[1]何丽清,蔡序子,王艳,等.子宫内膜异位症腹腔镜保守治疗术后联用GnRHa对临床妊娠率的影响[J].南方医科大学学报,2018,(05):596.
点击复制

子宫内膜异位症腹腔镜保守治疗术后联用GnRHa对临床妊娠率的影响()
分享到:

《南方医科大学学报》[ISSN:/CN:]

卷:
期数:
2018年05期
页码:
596
栏目:
出版日期:
2018-05-15

文章信息/Info

Title:
Effect of GnRHa therapy following conservative laparoscopic surgery for endometriosis on clinical pregnant rate in patients with endometriosis-associated infertility
作者:
何丽清蔡序子王艳王雪峰
关键词:
子宫内膜异位症腹腔镜手术促性腺激素释放激素激动剂妊娠率
Keywords:
endometriosis laparoscopic surgery gonadotropin-releasing hormone agonistPregnant rate
摘要:
目的探讨腹腔镜保守治疗术后是否联用促性腺激素释放激素激动剂(GnRHa)对子宫内膜异位症(EMT)合并不孕症患 者临床妊娠的影响。方法回顾性分析2011年1月~2016年12月因EMT合并不孕症行腹腔镜手术患者临床资料,将患者按术 后是否联合使用GnRHa分为单纯手术组和GnRHa组,追踪随访患者术后不同时间点的妊娠情况并统计分析。结果对于中重 度EMT,GnRHa组妊娠率较单纯手术组妊娠率有显著的统计学差异(P<0.05)。GnRHa组停用GnRHa后6月、12月、24月、36月 妊娠率较单纯手术组术后在相应四个时间点皆有统计学差异(P<0.05)。对于单纯手术组,术后体外受精-胚胎移植(IVF-ET)妊 娠率比自然妊娠率有显著性差异(P<0.05);而GnRHa组,则无显著性差异(P<0.05)。结论术后联用GnRHa并不能提高轻度 EMT患者的妊娠率,但可明显提高中重度EMT患者的妊娠率;单纯手术术后及联用GnRHa停药后半年内是妊娠的“黄金时 间”,妊娠率占3年累计妊娠率约50%。
Abstract:
Objective To investigate the impact of conservative laparoscopic surgery for endometriosis with postoperative gonadotropin-releasing hormone agonist (GnRHa) therapy on the pregnancy outcomes in patients with endometriosisassociated infertility. Methods The clinical data were collected from the patients with endometriosis-associated infertility undergoing conservative laparoscopic surgery in our department between January, 2011 and December, 2016. The patients were divided into laparoscopic surgery only group (without any other treatments) and postoperative GnRha therapy group, and the pregnancy outcomes were compared between the two groups at different time points during the follow-up. Results In cases with moderate or severe endometriosis, laparoscopic surgery with postoperative GnRha therapy was associated with a significantly higher clinical pregnancy rate than laparoscopic surgery alone (P<0.05). In patients receiving postoperative GnRha therapy, the accumulative pregnancy rates at 6, 12, 24 and 36 months after discontinuation of GnRha therapy were significantly higher than those in patients receiving laparoscopic surgery alone. The pregnancy rate following IVF-ET cycles was significantly higher than the spontaneous pregnancy rate in patients receiving conservative laparoscopic surgery alone (P< 0.05), while such a difference was not found in patients with postoperative GnRHa therapy (P>0.05). Conclusions GnRHa therapy after conservative laparoscopic surgery can significantly increase the clinical pregnancy rate in infertile 6 months women with moderate or severe endometriosis but not in mild cases. Within 6 months following laparoscopic surgery or following discontinuation of GnRHa therapy is the optimal time window for pregnancy, and a longer time from therapy discontinuation is associated with a lower possibility of spontaneous pregnancy.

相似文献/References:

[1]易华,卢月,陈剑坤,等. 青藤碱对子宫内膜异位症大鼠异位组织TNF-琢和NF-资B 水平的影响[J].南方医科大学学报,2010,(08):1874.
 YI Hua,LU Yue,CHEN Jian-kun,et al.Effect of sinomenine on tumor necrosis factor-琢and nuclear factor-资B in the heterotopictissue in rats with endometriosis[J].,2010,(05):1874.
[2]李洁,汪淑娟,孙璐,等.抑癌基因ARHI 在子宫内膜异位症及非子宫内膜异位症患者中差异表达的意义[J].南方医科大学学报,2011,(05):796.
[3]李国新,闫鸿涛,余江,等.腹腔镜直肠癌切除术的学习曲线[J].南方医科大学学报,2006,(04):535.
 LI Guo-xin,YAN Hong-tao,YU-Jiang,et al.Learning curve of laparoscopic resection for rectal cancer[J].,2006,(05):535.
[4]罗敏,何援利,张宏斌,等.广东妇女子宫内膜异位症与肿瘤坏死因子-β基因多态性的相关性研究[J].南方医科大学学报,2006,(08):1163.
 LUO Min,HE Yuan-li,ZHANG Hong-bin,et al.Association of tumor necrosis factors-β gene polymorphism with endometriosis in women in Guangdong Province[J].,2006,(05):1163.
[5]钟秉政,刘峰,余江,等.腹腔镜与同期开腹直肠癌切除术后长期肿瘤学结果的对比研究[J].南方医科大学学报,2012,(05):664.
[6]宗利丽,李亚里,宋三泰,等.子宫内膜异位症患者肝细胞生长因子及其受体c-Met的表达[J].南方医科大学学报,2004,(06):619.
 ZONG Li-li,LI Ya-li,SONG San-tai,et al.Expression of hepatocyte growth factor and its receptor c-met gene in the endometrium of women with endometriosis[J].,2004,(05):619.
[7]赵军,宗利丽,李亚里.整合素avβ3单克隆抗体对小鼠子宫内膜异位病灶的抑制作用[J].南方医科大学学报,2005,(06):709.
 ZHAO Jun,ZONG Li-li,LI Ya-li.Inhibitory effects of integrin avβ3 monoclonal antibody on implanted lesions of endometriosis model of SCID mouse[J].,2005,(05):709.
[8]刘木彪,何援利,彭冬先.子宫内膜异位症患者腹腔液血管内皮生长因子与内抑素的表达[J].南方医科大学学报,2004,(01):69.
 LIU Mu-biao,HE Yuan-li,PENG Dong-xian.Expression of vascular endothelial growth factor and endostatin in peritoneal fluid of patients with endometriosis[J].,2004,(05):69.
[9]蔡珠华,何援利,彭冬先.子宫内膜异位症患者血清中ENA-78的表达[J].南方医科大学学报,2005,(04):464.
 CAI Zhu-hua,HE Yuan-li,PENG Dong-xian.Changes of serum epithelial neutrophil-activating peptide-78 in patients with endometriosis[J].,2005,(05):464.
[10]王芳,何援利,彭冬先,等.子宫内膜异位症患者核转录因子-κB及细胞间粘附分子-1的表达[J].南方医科大学学报,2005,(06):703.
 WANG Fang,HE Yuan-li,PENG Dong-xian,et al.Expressions of nuclear factor-kappaB and intercellular adhesion molecule-1 in endometriosis[J].,2005,(05):703.

更新日期/Last Update: 1900-01-01