腹腔镜手术治疗输卵管憩室合并子宫内膜异位症患者的妊娠结局分析

发布时间：2018-06-27 11:35

本文选题：输卵管憩室 + 腹腔镜　；参考：《中国妇产科临床杂志》2015年04期

【摘要】：目的探讨输卵管憩室与子宫内膜异位症(内异症)的关系及其治疗的效果。方法回顾性分析2010年1月至2014年1月腹腔镜手术治疗的53例输卵管憩室患者的临床资料。术后随访12~18个月,统计妊娠率、流产率及持续妊娠率。结果 53例患者中,经腹腔镜诊断为内异症者84.9%(45/53),非内异症患者15.1%(8/53);术中荷包缝合输卵管憩室,同时去除盆腔内异症病灶及其他输卵管异常,术后自然妊娠率为83.0%(44/53),自然流产率为3.8%(2/53)。其中91.1%(41/45)合并内异症患者术后给予促性腺激素释放激素激动剂(GnRH-a)治疗。GnRHa治疗者术后一年内自然妊娠率为90.2%(37/41)。4例未经GnRH-a治疗的内异症患者术后自然妊娠1例,8例无内异症患者,术后自然妊娠率6例。结论输卵管憩室可能与内异症和不孕症有关。经腹腔镜治疗及对合并内异症患者术后辅助GnRH-a治疗有利于提高妊娠率。
[Abstract]:Objective to investigate the relationship between tubal diverticulum and endometriosis. Methods the clinical data of 53 patients with tubal diverticulum treated by laparoscopic surgery from January 2010 to January 2014 were retrospectively analyzed. After 12 ~ 18 months follow-up, pregnancy rate, abortion rate and continuous pregnancy rate were calculated. Results among the 53 patients, 84.9% (45 / 53) and 15.1% (8 / 53) were diagnosed as endoscopes by laparoscope and 15.1% (8 / 53) by non-endoscopes, and 83.0% (44 / 53) were spontaneous pregnancy and 3.8% (2 / 53) were spontaneous abortion after operation by suturing the tubal diverticulum and removing the lesions of pelvic endosalpinx and other fallopian tube abnormalities. Among them, 91.1% (41 / 45) of patients with endometriosis were treated with gonadotropin releasing hormone agonist (GnRH-a). The rate of spontaneous pregnancy was 90.2% (37 / 41) within one year after treatment with gonadotropin releasing hormone agonist (GnRH-a). The spontaneous pregnancy rate was 6 cases after operation. Conclusion tubal diverticulum may be associated with endometriosis and infertility. Laparoscopy and postoperative GnRH-a therapy for patients with endometriosis were helpful to improve pregnancy rate.
【作者单位】：北京大学人民医院计划生育与生殖科;
【分类号】：R711.6

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