冯彦娜 肖雁冰

【摘要】目的：探讨腹腔镜手术联合醋酸曲普瑞林治疗子宫内膜异位合并不孕症的疗效。方法：选择2012年1月至2014年6月来我院就诊的子宫内膜异位合并不孕症患者132例，根据随机抽签原则分为治疗组与对照组各66例，所有患者都给予腹腔镜下手术治疗，治疗组术后3d后采用醋酸曲普瑞林治疗，对照组给予孕三烯酮治疗，持续应用6个月。结果：治疗组的术后住院时间以及疼痛持续时间为（5.13±1.33）d和（6.64±0.73）d，明显少于对照组的（6.63±1.54）d和（10.98±1.11）d（P<0.05）。治疗后治疗组与对照组的总有效率分别为98.5%和90.9%，治疗组的总有效率高于对照组。治疗组与对照组治疗后的血清白血病抑制因子含量分别为（12.35±0.466）μmol/L和（9.13±1.25）μmol/L，都明显高于治疗前的（6.25±1.31）μmol/L和（6.15±2.13）μmol/L（P<0.05），同时组间对比差异也有统计学意义（P<0.05）。治疗组术后6个月与1年的妊娠率为33.3%和51.5%，对照组为18.2%和31.8%，治疗组明显高于对照组（P<0.05）。结论：腹腔镜手术联合醋酸曲普瑞林治疗子宫内膜异位合并不孕症能促进患者近期康复，有效提高白血病抑制因子的表达，从而改善总体治疗效果，提高远期妊娠率。

【关键词】腹腔镜手术；醋酸曲普瑞林；子宫内膜异位症；不孕

【Abstract】Objectives： To evaluate the efficacy of aparoscopic surgery combined with triptorelin acetate treatment for endometriosis combined with infertility. Methods： 132 infertile patients with endometriosis in our hospital from January 2012 to June 2014 were selected and randomly divided into treatment group and control group， each of 66 patients. All patients were given intraperitoneal endoscopic surgery. The treatment group received triptorelin acetate treatment from the 3rd day after treatment while the control group was given gestrinone treatment， both for six months. Results： The postoperative hospital stay and duration of pain in the treatment group were 5.13 ± 1.33d and 6.64 ± 0.73d respectively， significantly less than the control group of 6.63 ± 1.54d and 10.98 ± 1.11d （P<0.05）. The total effective rates in the treatment group and the control group were 98.5% and 90.9% respectively. The serum leukemia inhibitor contents in the treatment group and control group after treatment were 12.35 ± 0.466umol / L and 9.13 ± 1.25umol / L， which were significantly higher than before treatment of 6.25 ± 1.31umol / L and 6.15 ± 2.13umol / L （P<0.05）， with statistically significant differences between the two groups （P<0.05）. The 6 months and 1-year pregnancy rates in the treatment group after treatment were 33.3% and 51.5%， and those in the control group were 18.2% and 31.8% （P<0.05）. Conclusion： Laparoscopic surgery combined with triptorelin acetate treatment of endometriosis combined with infertility can promote the rehabilitation of patients， which can effectively improve the leukemia inhibitory factor， thereby improving the overall treatment efficacy and long-term pregnancy rate.

【Key words】Laparoscopic surgery； Triptorelin acetate； Endometriosis； Infertility

【中图分类号】R711.74【文献标志码】A

子宫内膜异位症（endometriosis ，EM）当前在我国的发病率为3.0%左右[1，2]。而不孕群体中子宫内膜异位症的发病率在30.0%以上，且子宫内膜异位合并不孕症的几率在40.0%，也表现为进行性痛经加重、性交痛、盆腔痛等症状，严重影响妇女的身心健康与生活质量[3，4]。在治疗中，腹腔镜手术可诊断子宫内膜异位症的类型及病变程度，且能有效清除病灶，再构盆腔解剖结构，并对不孕预后进行分期、评估，提升妊娠率[5，6]。当前子宫内膜异位症也被认为是一种激素依赖性疾病，促性腺激素释放激素激动剂是目前治疗子宫内膜异位症对有效且副作用相对较小的辅助药物，其中醋酸曲普瑞林是长效促性腺激素释放激素激动剂的一种[7，8]。本文具体观察了腹腔镜手术联合醋酸曲普瑞林治疗子宫内膜异位合并不孕症的疗效。现报道如下。

1资料与方法

1.1一般资料

选择2012年1月至2014年6月来我院就诊的子宫内膜异位合并不孕症患者132例。……