[1]刘冬,宋豪,郭春,等.腹腔镜联合药物治疗轻度子宫内膜异位症合并不孕的疗效分析[J].中国微创外科杂志,2011,11(5):415-417.
　Liu Dong,Song Hao,Guo Chun,et al.Laparoscopy Combined with Gestrinone or Oral Contraceptive Pills for Infertile Women with Minimalmild Endometriosis[J].Chinese Journal of Minimally Invasive Surgery,2011,11(5):415-417.
点击复制

腹腔镜联合药物治疗轻度子宫内膜异位症合并不孕的疗效分析()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
11
期数:
2011年5期
页码:
415-417
栏目:
出版日期:
2011-05-20

文章信息/Info

Title:
Laparoscopy Combined with Gestrinone or Oral Contraceptive Pills for Infertile Women with Minimalmild Endometriosis
作者:
刘冬; 宋豪; 郭春; 刘尧芳; 肖丽; 黄薇
四川大学华西第二医院妇产科,成都610041
Author(s):
Liu Dong;  Song Hao;  Guo Chun;  et al.
Department of Obstetrics and Gynecology, West China Second Hospital, Sichuan University, Chengdu 610041, China
关键词:
子宫内膜异位症; 不孕; 腹腔镜;  孕三烯酮; 口服避孕药
Keywords:
Endometriosis; Infertility; Laparoscopy; Gestrinone; Oral contraceptive pills
分类号:
R711.71
文献标志码:
A
摘要:
目的探讨腹腔镜手术联合不同药物治疗轻度子宫内膜异位症（内异症）合并不孕的疗效。方法回顾性分析2004年1月~2009年12月110例腹腔镜诊断轻度内异症（rAFS Ⅰ~Ⅱ期）合并不孕患者的临床资料，按术后使用药物情况分为2组：避孕药组53例，服用口服避孕药去氧孕烯炔雌醇片（妈富隆）或屈螺酮炔雌醇片（优思明）每天1片×21天，月经来潮第1天开始服药，连用3个月；孕三烯酮组57例，服用孕三烯酮每次2.5 mg，每周2次，连用3个月。比较2组术后妊娠情况和妊娠结局。结果其中104例完成3个月药物治疗，术后随访时间（24.0±8.2）月（11~41个月），妊娠率39.4％（41/104），活产率356%（37/104）。术后1年内、1~2年和2年以上的妊娠率分别为26.9%（28/104）、12.2%（9/74）和91%（4/44），术后1年的妊娠率明显高于1~2年及2年以上者（χ2=5.721，P=0.017； χ2=5.802，P=0.016）。2组妊娠率［46.0%(23/50) vs. 33.3%(18/54)， χ2=1.744，P=0.187］和活产率［42.0%（21/50） vs. 29.6%（16/54）， χ2=1.733，P=0.188］差异无显著性。结论对于合并轻度内异症的不孕患者，腹腔镜联合术后孕三烯酮或口服避孕药治疗均有效改善其生育力。
Abstract:
ObjectiveTo evaluate the effectiveness of laparoscopic surgery combined with gestrinone or oral contraceptive pills (OCP) in the treatment of infertile women with minimalmild endometriosis (EMs)．MethodsA retrospective analysis on the clinical materials and followup pregnant outcomes of 110 infertile women with minimalmild EMs, who were treated in our hospital from January 2004 to December 2009. Gestrinone (n=57) or OCP (n=53) was administered for three months after laparoscopic surgery．In OCP group, the patients received Marvelon or Yasmin 1 tablet/d × 21 days, started from the first day of a period. While in gestrinone group, gestrinone 2.5 mg twice a week was given. ResultsAmong these 110 cases, 104 patient finished the treatment ［mean followup （24.0±8.2） months, ranged from 11 to 41 months］, the pregnancy rate and live birth rate was 39.4% (41/104) and 35.6% (37/104) respectively. The lessthan1year pregnancy rate was 26.9% (28/104), which was significantly higher than that at 1-2, and over 2 years ［12.2% (9/74), χ2=5.721, P=0.017 and 9.1% (4/44), χ2=5.802, P=0.016, respectively］. No significant difference was found in the pregnancy rate and live birth rate between the two groups ［46.0% (23/50) vs. 33.3% (18/54), χ2=1.744, P=0.187; and 42.0% (21/50) vs. 29.6% (16/54), χ2=1.733, P=0.188, respectively］.ConclusionAfter laparoscopic surgery, either gestrinone or OCP can improve the fecundity in infertile women with minimalmild EMs.

参考文献/References:

[1]The Practice Committee of the American Society for Reproductive Medicine.Endometriosis and infertility.Fertil Steril,2006,86:S156-S160.
[2]Pritts EA,Taylor RN.An evidencebased evaluation of endometriosisassociated infertility.Gynecol Obstet Invest,2009,67:81-91.
[3]Jacobson TZ，Barlow DH，Koninckx PR，et al．Laparoscopic surgery for subfertility associated with endometriosis．Coche Data Syst Rev,2010(1):CD001398.
[4]冷金花,张羽.腹腔镜在子宫内膜异位症中的应用现状及局限性.中国实用妇科与产科杂志，2010,24:6-8.
[5]Yap C,Furness S,Farquhar C.Pre and post operative medical therapy for endometriosis surgery.Coch Data Syst Rev,2004,(3)：CD003678．
[6]American society for Reproductive Medicine.Revised American Society for reproductive medicine classification of endometriosis:1996.Fertil Steril,1997,67:817-821.
[7]薛素华,黄婉,黄燕清.腹腔镜手术治疗子宫内膜异位症伴不孕378例分析.中国微创外科杂志,2003,3:233-234.
[8]Marcous S,Maheux R,Brub S.Laparoscopic surgery in infertile women with minimal or mild endometriosis:Canadian Collaborative Group on Endometriosis.N Eng J Med,1997,337:217-222.
[9]Rickes D,Nickel I,Kropf S,et al.Increased pregnancy rates after ultralong postoperative therapy with gonadotropin releasing hormone analogs in patients with endometriosis.Fertil Steril,2007,78:757-762.
[10]Vercellini P,Crosignani PG,Fadini R,et al.A gonadotropinreleasing hormone agonist compared with expectant management after conservative surgery for symptomatic endometriosis.Br J Obstet Gynaecol,1999,106:672-677.
[11]李翠玲,李晓吉,马玉兰,等.腹腔镜手术治疗子宫内膜异位症伴不孕104例.中国微创外科杂志,2009,9:790-792.
[12]万筱慧,马琳,肖福珍.腹腔镜手术联合药物治疗子宫内膜异位症58例分析.中国微创外科杂志,2007,7:767-768.

备注/Memo

备注/Memo:
黄薇通讯作者，Email：weihuang64@163.com
更新日期/Last Update: 2013-04-18