【摘要】：目的:探討中重度子宮內(nèi)膜異位癥(EMT)合并不孕患者在單純腹腔鏡術(shù)后與腹腔鏡術(shù)后應(yīng)用促性腺激素釋放激素類似物(GnRH-a)對(duì)妊娠的影響。方法:選取2011年1月-2013年12月期間在江西省婦幼保健院收治的中重度子宮內(nèi)膜異位癥(III、IV期)合并不孕癥患者144例作為研究對(duì)象,根據(jù)患者術(shù)后意愿分為對(duì)照組、觀察組。對(duì)照組為單純腹腔鏡術(shù)后,觀察組為腹腔鏡術(shù)后應(yīng)用促性腺激素釋放激素類似物(GnRH-a)。所有患者術(shù)后隨訪2年,比較兩組患者的妊娠率及流產(chǎn)率情況。結(jié)果:1年內(nèi),觀察組的妊娠率45/80(56.25%)高于對(duì)照組17/64(26.56%);2年內(nèi),觀察組的妊娠率47/80(58.57%)高于對(duì)照組18/64(28.12%);觀察組第1年的妊娠率45/80(56.25%)高于第2年妊娠率2/80(2.5%),對(duì)照組第1年的妊娠率17/64(26.25%)高于第2年妊娠率1/64(1.56%);2年內(nèi)觀察組的流產(chǎn)例數(shù)7例(15%),對(duì)照組3例(16.7%)。結(jié)論:中重度內(nèi)異癥合并不孕患者腹腔鏡術(shù)后應(yīng)用GnRH-a較單純腹腔鏡術(shù)后相比能提高術(shù)后妊娠率;在妊娠時(shí)間上,無(wú)論單純腹腔鏡術(shù)后還是腹腔鏡術(shù)后應(yīng)用GnRH-a在術(shù)后1年內(nèi)妊娠率較高,1年后妊娠率趨于平穩(wěn),因此內(nèi)異癥合并不孕患者爭(zhēng)取在術(shù)后1年內(nèi)妊娠,如術(shù)后1年仍未妊娠應(yīng)盡早行輔助生殖技術(shù)(ART)助孕。
[Abstract]:Objective: to investigate the effect of gonadotropin releasing hormone analogue (GnRH-a) on pregnancy in patients with moderate and severe endometriosis (EMT) complicated with infertility after laparoscopic and laparoscopic surgery. Methods: 144 cases of moderate and severe endometriosis (stage IIIIV) with infertility were selected from January 2011 to December 2013 in Jiangxi Maternal and Child Health Care Hospital. The patients were divided into control group and observation group according to the wishes of the patients. The control group was treated with laparoscopy alone and the observation group with gonadotropin releasing hormone analogue (GnRH-a). All patients were followed up for 2 years to compare the pregnancy rate and abortion rate. Results: within one year, the pregnancy rate in the observation group was 45 / 80 (56.25%) higher than that in the control group 17 / 64 (26.56%), within 2 years, The pregnancy rate of the observation group was 47 / 80 (58.57%) higher than that of the control group (28.12%), the pregnancy rate of the observation group in the first year was 45 / 80 (56.25%) higher than that in the second year (2.5%), the pregnancy rate of the control group in the first year was 17 / 64 (26.25%) higher than that in the second year (1.56%), the number of miscarriages in the observation group was 15% (7 cases) and that in the control group (3 cases (716.716.%). Conclusion: the pregnancy rate of patients with moderate or severe endometriosis complicated with infertility after laparoscopic operation is higher than that of laparoscopy alone, and the pregnancy time is higher than that of laparoscopy alone. The pregnancy rate of GnRH-a after laparoscopy or laparoscopic surgery was higher within 1 year after operation, and the pregnancy rate tended to be stable after one year, so the patients with endometriosis and infertility were trying to get pregnant within 1 year after operation. If the pregnancy is not 1 year after operation, the assisted reproductive technique (ART) should be performed as soon as possible.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R713

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