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目的探讨术后辅助非周期应用促性腺激素释放激素激动剂(GnRH-α)对重度卵巢子宫内膜异位症患者卵巢储备功能及生育的影响。方法腹腔镜卵巢囊肿剔除术患者150例分为三组:A组50例,为卵巢成熟性囊性畸胎瘤;重度卵巢子宫内膜异位囊肿患者100例中,52例术后周期应用GnRH-α治疗(B组),48例术后非周期应用GnRH-α治疗(C组)。随访1年,比较性激素[卵泡刺激素(FSH),黄体生成素(LH),雌二醇(E_2)]水平、窦状卵泡数(AFC)、卵巢间质动脉血流的收缩期峰值(PSV)变化及妊娠结局。结果 A组手术前、术后的FSH、LH、E_2、AFC和PSV均无明显变化(P>0.05)。术后3个月,B、C组的上述指标均低于A组,C组高于B组(P<0.05);术后6个月,B组的上述指标低于A、C组(P<0.05),但A、C组比较无统计学差异(P>0.05)。A组妊娠率90.0%,高于B和C组的35.3%和53.3%(P<0.05),C组妊娠率稍高于B组(P>0.05)。结论对重度卵巢子宫内膜异位症患者,术后非周期应用GnRH-α较周期应用对卵巢功能影响小,可提高子宫内膜异位症不育患者的妊娠率。
Objective To investigate the effect of postoperative adjuvant non-periodic administration of gonadotropin-releasing hormone agonist (GnRH-α) on ovarian reserve and fertility in patients with severe ovarian endometriosis. Methods 150 patients with laparoscopic ovarian cyst excision were divided into three groups: group A, 50 cases of mature ovarian cystic teratoma; 100 cases of severe ovarian endometriosis patients, 52 cases of postoperative GnRH -α treatment (group B), and 48 patients were treated with GnRH-α after aperiodic non-periodicity (group C). After one year of follow-up, the levels of sex hormones (follicle stimulating hormone, LH and E2), the number of antral follicles (AFC) and the peak systolic peak of ovarian interstitial blood flow (PSV ) Changes and pregnancy outcomes. Results There was no significant change in FSH, LH, E_2, AFC and PSV before and after operation in group A (P> 0.05). At 3 months after operation, the above indexes in group B and group C were lower than those in group A, while those in group C were higher than those in group B (P <0.05). At 6 months after operation, the above indexes in group B were lower than those in group A and C <0.05), but there was no significant difference between A and C groups (P> 0.05). The pregnancy rate in group A was 90.0%, higher than 35.3% and 53.3% in group B and C (P <0.05). The pregnancy rate in group C was slightly higher than that in group B (P> 0.05). Conclusion In patients with severe ovarian endometriosis, the non-periodic application of GnRH-α has less effect on ovarian function than that of periodic application, and can improve the pregnancy rate of infertility patients with endometriosis.