首页|腹腔镜联合亮丙瑞林治疗EMS伴不孕疗效及对血清性激素影响

腹腔镜联合亮丙瑞林治疗EMS伴不孕疗效及对血清性激素影响

Curative effect of laparoscopy combined with leuprorelin for treating infertility patients with endometriosis and its influ-ences on the serum sex hormone levels of the patients

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目的:观察腹腔镜联合亮丙瑞林治疗子宫内膜异位症(EMS)伴不孕疗效及对血清雌二醇(E2)、卵泡刺激素(FSH)和抗缪勒管激素(AMH)的影响.方法:选取2019年4月—2022年4月本院接受治疗的EMS伴不孕患者103例,以接受腹腔镜治疗为对照组(52例),接受腹腔镜联合亮丙瑞林治疗为联合组(51例).比较两组手术后治疗总有效率,手术前后血清FSH、E2、AMH水平,血清肿瘤标志物糖链抗原125(CA125)、糖链抗原199(CA199)水平;两组并发症及术后1年妊娠率、复发率.结果:术后3个月,联合组总有效率(90.2%)高于对照组(73.1%);术后6个月联合组血清FSH、E2水平均低于对照组(P<0.05),两组AMH无差异(P>0.05),联合组血清CA125(21.64±4.36 U/L)、CA199(24.36±2.24 U/L)水平均低于对照组(33.70±6.92 U/L、35.48±3.22 U/L)(P<0.05).术后 1 年联合组妊娠率(86.3%)高于对照组(44.2%),复发率(7.8%)低于对照组(23.1%)(均P<0.05).两组治疗期间并发症发生率(9.8%、5.8%)无差异(P>0.05).结论:腹腔镜辅助亮丙瑞林治疗EMS伴不孕能够显著提高治疗效果,改善血清性激素及肿瘤标志物水平,提高妊娠率,减少复发,且安全性较好.
Objective:To observe the curative effect of laparoscopy combined with leuprorelin for treating infertility pa-tients with endometriosis(EMS),and to study its influences on the levels of serum estradiol(E2),follicle-stimulating hormone(FSH)and anti-Mullerian hormone(AMH)of the patients.Methods:The clinical data of 103 infertility pa-tients with EMS and treated in the hospital between April 2019 and April 2022 were selected in this study.52 patients who had been treated by laparoscopy were included in control group and 51 patients who had been treated by laparosco-py combined with leuprorelin were selected in experimental group.The total effect rate of treatment after surgery,the levels of serum FSH,E2 and AMH,and the levels of the serum tumor markers,such as carbohydrate antigen 125(CA125)and CA199 before and after surgery of the patients were compared between the two groups.The occurrence of complication and the rates of pregnancy and EMS recurrence after 1 year of surgery of the patients were also com-pared between the two groups.Results:The total effective rate(90.2%)of the patients in the experimental group in the 3rd month after surgery was significantly higher than that(73.1%)of the patients in the control group.The levels of serum FSH and E2 of the patients in the experimental group in the 6th month after surgery were significantly lower than those of the patients in the control group(P<0.05).There was no significant difference in the AMH level of the patients between the two groups(P>0.05).The serum levels of CA125(21.64±4.36 U/L)and CA199(24.36±2.24 U/L)of the patients in the experimental group were significantly lower than those(33.70±6.92 U/L and 35.48±3.22 U/L)of the patients in the control group(P<0.05).The pregnancy rate(86.3%)of the patients in the experimental group within 1 year after surgery was significantly higher than that(44.2%)of the patients in the control group,and the EMS recurrence rate(7.8%)of the patients in the experimental group was significantly lower than that(23.1%)of the patients in the control group(all P<0.05).There was no significant difference in the incidence of complications(9.8%vs.5.8%)of the patients between the two groups(P>0.05).Conclusion:Laparoscopy combined with leupro-relin for treating infertility patients with EMS can significantly improve their curative effect,and levels of serum sex hormones and tumor markers,increase their pregnancy rate and reduce their recurrence,and with higher safety.

EndometriosisInfertilityLaparoscopyLeuprorelinCurative effectSex hormoneRecurrencePreg-nancy

伏清欢、张艺霁、陈妍、李元宏

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四川省成都市中西医结合医院,成都市第一人民医院(610041)

子宫内膜异位症 不孕症 腹腔镜 亮丙瑞林 疗效 性激素 复发 妊娠

四川省医学会专项科研课题

2019HR65

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(3)
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