腹腔鏡手術聯合醋酸曲普瑞林治療子宮內膜異位合并不孕癥的療效觀察

馮彥娜 肖雁冰

【摘要】目的：探討腹腔鏡手術聯合醋酸曲普瑞林治療子宮內膜異位合并不孕癥的療效。方法：選擇2012年1月至2014年6月來我院就診的子宮內膜異位合并不孕癥患者132例，根據隨機抽簽原則分為治療組與對照組各66例，所有患者都給予腹腔鏡下手術治療，治療組術后3d后采用醋酸曲普瑞林治療，對照組給予孕三烯酮治療，持續應用6個月。結果：治療組的術后住院時間以及疼痛持續時間為（5.13±1.33）d和（6.64±0.73）d，明顯少于對照組的（6.63±1.54）d和（10.98±1.11）d（P<0.05）。治療后治療組與對照組的總有效率分別為98.5%和90.9%，治療組的總有效率高于對照組。治療組與對照組治療后的血清白血病抑制因子含量分別為（12.35±0.466）μmol/L和（9.13±1.25）μmol/L，都明顯高于治療前的（6.25±1.31）μmol/L和（6.15±2.13）μmol/L（P<0.05），同時組間對比差異也有統計學意義（P<0.05）。治療組術后6個月與1年的妊娠率為33.3%和51.5%，對照組為18.2%和31.8%，治療組明顯高于對照組（P<0.05）。結論：腹腔鏡手術聯合醋酸曲普瑞林治療子宮內膜異位合并不孕癥能促進患者近期康復，有效提高白血病抑制因子的表達，從而改善總體治療效果，提高遠期妊娠率。

【關鍵詞】腹腔鏡手術；醋酸曲普瑞林；子宮內膜異位癥；不孕

【Abstract】Objectives： To evaluate the efficacy of aparoscopic surgery combined with triptorelin acetate treatment for endometriosis combined with infertility. Methods： 132 infertile patients with endometriosis in our hospital from January 2012 to June 2014 were selected and randomly divided into treatment group and control group， each of 66 patients. All patients were given intraperitoneal endoscopic surgery. The treatment group received triptorelin acetate treatment from the 3rd day after treatment while the control group was given gestrinone treatment， both for six months. Results： The postoperative hospital stay and duration of pain in the treatment group were 5.13 ± 1.33d and 6.64 ± 0.73d respectively， significantly less than the control group of 6.63 ± 1.54d and 10.98 ± 1.11d （P<0.05）. The total effective rates in the treatment group and the control group were 98.5% and 90.9% respectively. The serum leukemia inhibitor contents in the treatment group and control group after treatment were 12.35 ± 0.466umol / L and 9.13 ± 1.25umol / L， which were significantly higher than before treatment of 6.25 ± 1.31umol / L and 6.15 ± 2.13umol / L （P<0.05）， with statistically significant differences between the two groups （P<0.05）. The 6 months and 1-year pregnancy rates in the treatment group after treatment were 33.3% and 51.5%， and those in the control group were 18.2% and 31.8% （P<0.05）. Conclusion： Laparoscopic surgery combined with triptorelin acetate treatment of endometriosis combined with infertility can promote the rehabilitation of patients， which can effectively improve the leukemia inhibitory factor， thereby improving the overall treatment efficacy and long-term pregnancy rate.

【Key words】Laparoscopic surgery； Triptorelin acetate； Endometriosis； Infertility

【中圖分類號】R711.74【文獻標志碼】A

子宮內膜異位癥（endometriosis ，EM）當前在我國的發病率為3.0%左右[1，2]。而不孕群體中子宮內膜異位癥的發病率在30.0%以上，且子宮內膜異位合并不孕癥的幾率在40.0%，也表現為進行性痛經加重、性交痛、盆腔痛等癥狀，嚴重影響婦女的身心健康與生活質量[3，4]。在治療中，腹腔鏡手術可診斷子宮內膜異位癥的類型及病變程度，且能有效清除病灶，再構盆腔解剖結構，并對不孕預后進行分期、評估，提升妊娠率[5，6]。當前子宮內膜異位癥也被認為是一種激素依賴性疾病，促性腺激素釋放激素激動劑是目前治療子宮內膜異位癥對有效且副作用相對較小的輔助藥物，其中醋酸曲普瑞林是長效促性腺激素釋放激素激動劑的一種[7，8]。本文具體觀察了腹腔鏡手術聯合醋酸曲普瑞林治療子宮內膜異位合并不孕癥的療效。現報道如下。

1資料與方法

1.1一般資料

選擇2012年1月至2014年6月來我院就診的子宮內膜異位合并不孕癥患者132例?！?br>