不同手术方式剥除卵巢子宫内膜异位囊肿对卵巢功能的影响.docVIP

不同手术方式剥除卵巢子宫内膜异位囊肿对卵巢功能的影响 nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp; nbsp; 作者：赵淑芹，武玉玲，王晓莉nbsp; 【摘要】nbsp; 目的 探讨不同手术方式剥除卵巢子宫内膜异位症囊肿对卵巢功能的影响。方法 对 67例既往开腹或腹腔镜确诊的子宫内膜异位症合并不育患者行体外受精-胚胎移植术卵巢控制性超促排卵（COH）和助孕结局进行回顾性分析。将这些病例分为A、B、C三组：A组21例，曾行腹腔镜卵巢子宫内膜异位囊肿剥除术；B组16 例，曾行开腹卵巢子宫内膜异位囊肿剥除术；C组30 例，为未行囊肿剥除术的子宫内膜异位症患者。结果 A、B两组COH中的获卵数、受精率、优质胚胎数、移植胚胎数、妊娠率与C组相比,差异均无显著性（P＞0.05），但其促性腺激素用量及用药天数明显多于对照组。两种手术组卵巢中的窦卵泡数均少于非手术组（P＜0.05），其血清中FSH、E2均高于非手术组（P＜0.05），而两种手术组间差异无显著性（P＞0.05）。患者手术侧卵巢与未手术侧相比 ,体积较小,但二者之间差异无显著性 ；在HCG注射日，手术组中直径≥14mm的窦卵泡数均明显少于未手术组（P＜0.05）。结论 两种方式的手术剥除卵巢子宫内膜异位症囊肿均可影响卵巢功能 ,减低卵巢储备能力。 【关键词】nbsp; 卵巢子宫内膜异位囊肿；卵巢囊肿剥除术；体外受精-胚胎移植；卵巢控制性超促排卵（COH） nbsp;nbsp;nbsp; 【Abstract】nbsp; Objectivenbsp; To investigate different operating ways to excision of ovarian endometriosis prior to IVF-ET affects ovarian response of controlled ovarian hyperstimulation （COH）and fertility outcomes.Methodsnbsp; A retrospective study on 67women with ovarian endometriomas （previously diagnosed by open or laparoscopic surgery ） receiving COH for IVF-ET regarding their outcomes of assisted reproduction. A group:21 patients had received a laparoscopic cystectomy; B group:16patients had undergone an open cystectomy; C group:30 patients had been untreated with cystectomy.Resultsnbsp; Both laparoscopic and open cystectomy of ovarian endometriomas are no significant difference in number of superiority follicles, number of oocytes obtained, number of nomally developed embryos, number of embryos transferred and pregnancy rate. Numbers of antral follicles in the A and B group were significant fewer than the C group （Plt;0.05） .There was no difference in the dosage and duration of FSH application between laparoscopic and open cystectomy group（Pgt;0.05）, but the dosage and duration of follicle-stimalating hormone（FSH） application in the laparoscopic and open cystectomy groups were significantly increased than in the control group（