腹腔镜保守手术联合GnRHa治疗卵巢巧克力囊肿伴不孕临床观察.docVIP

腹腔镜保守手术联合GnRHa治疗卵巢巧克力囊肿伴不孕临床观察 　　【摘要】目的分析单纯腹腔镜保守手术联合GnRHa治疗卵巢巧克力囊肿伴不孕的效果。方法回顾性分析99例卵巢巧克力囊肿患者进行腹腔镜保守手术术后的随访资料，按术后是否使用GnRHa分为两组，对照组为单纯腹腔镜保守手术治疗共65例，术后鼓励患者生育；观察组为腹腔镜保守手术联合GnRHa治疗共34例，术后于首次月经第1天给予GnRHa 3.75 mg皮下注射，之后每28天皮下注射GnRHa 3.75 mg，连用3个月。全部患者随访12～24个月，比较两组患者盆腔疼痛缓解情况、复发率和妊娠率。结果观察组盆腔疼痛缓解情况优于对照组，差异有统计学意义（P0.05）；观察组和对照组Ⅰ～Ⅱ期患者的妊娠率分别为45.45%和36.36%，差异无统计学意义（P0.05）；而观察组和对照组Ⅲ～Ⅳ期患者的妊娠率分别为43.48%和18.75%，差异有统计学意义（P0.05）。结论腹腔镜保守手术联合GnRHa治疗卵巢巧克力囊肿较单纯腹腔镜保守手术治疗可以有效缓解患者盆腔疼痛症状，降低复发率，对于Ⅰ～Ⅱ期卵巢巧克力囊肿患者，术后联合GnRHa治疗并不能提高妊娠率，故应于术后尽快受孕，而对于Ⅲ～Ⅳ期卵巢巧克力囊肿患者，术后使用GnRHa联合治疗可以提高妊娠率，值得临床推广。 　　【关键词】卵巢巧克力囊肿；腹腔镜手术；GnRHa；不孕；复发率；妊娠率 　　中图分类号：R711.71文献标识码：ADOI：10.3969/j.issn2015.03.015 　　Clinical observation of laparoscopic conservative surgery combined 　　with GnRHa for ovarian chocolate cyst with infertility 　　CHEN Jiao，YU Dan，YANG Aiying 　　（Department of Gynecology and Obstetrics，Pingguo Maternal and 　　Child Care Hospital，Pingguo 531400，Guangxi，China） 　　【Abstract】ObjectiveTo analyze the curative effect of laparoscopic conservative surgery combined with GnRHa for treatment of chocolate cyst combined with infertility and the impact on pregnancy.MethodsFollowup data of 99 cases of ovarian chocolate cyst treated by laparoscopic conservative surgery were analyzed retrospectively.They were divided into control group（n=65） and observation group（n=34） according to whether or not postoperative GnRHa was used.The control group were just treated by laparoscopic conservative surgery，and they were encouraged to give birth to their babies after surgery.The observation group were given laparoscopic conservative surgery combined with GnRHa，after surgery，they were given 3.75 mg of GnRHa on the first day of the first menstruation by subcutaneous injection，and then 3.75 mg of GnRHa per time every 28 days was provided to them for successive three months.All the patients were given followup visits for 12-24 months.And pelvic pain relief，recurrence rates and pregnancy rates were compared between groups.Resu