标题：腹腔镜卵巢子宫内膜异位囊肿剥除术联合亮丙瑞林对卵巢储备功能及生育的影响

      作者：陈雪兰，陈光元，黄平，杨智红
    (深圳市松岗人民医院妇科，广东 深圳 518105)

      卷次： 2016年27卷16期

      【摘要】 目的 探讨腹腔镜卵巢子宫内膜异位囊肿剥除术联合亮丙瑞林对双侧卵巢子宫内膜异位囊肿 (OEM)
患者卵巢储备功能和生育的影响。方法 2013年1月至2015年1月就诊于深圳市松岗人民医院妇科的82例双侧
OEM患者按照随机数字表法均分为观察组和对照组，每组41例，对照组实施腹腔镜卵巢子宫内膜异位囊肿剥除术治
疗，观察组在对照组治疗基础上加用亮丙瑞林治疗，采用放射免疫法检测患者性激素水平，包括血清卵泡刺激素
(FSH)、雌二醇(E2)以及黄体生成激素(LH)水平。随访1年，统计患者囊肿复发率、再次妊娠时间以及再次妊娠率。
结果 观察组治疗后的FSH、E2以及LH水平分别为(8.02±2.08) mIU/mL、(58.52±6.25) pg/mL、(4.62±0.40) mIU/mL，
对照组为(9.89±2.04) mIU/mL、(51.04±5.82) pg/mL、(4.01±0.86) mIU/mL，组间差异均有统计学意义(P<0.05)；观察组中
合并不孕的13例患者术后再次妊娠9例，对照组合并不孕15例中术后再次妊娠6例，再次妊娠时间为(7.32±2.15)个
月，明显短于对照组的(9.06±1.58)个月，差异均有统计学意义(P<0.05)；观察组患者术后1年复发率为4.88% (2/41)，
明显低于对照组为17.07% (7/41)，差异有统计学意义(P<0.05)。结论 双侧OEM患者在腹腔镜卵巢子宫内膜异位
囊肿剥除术治疗前给予亮丙瑞林治疗，可有效减轻手术对卵巢储备功能的影响，提高再次妊娠率，降低复发率。

      【关键词】 子宫内膜异位囊肿；亮丙瑞林；腹腔镜；卵巢储备功能；生育

      【中图分类号】 R711.75 【文献标识码】 A 【文章编号】 1003—6350（2016）16—2638—03


Effect of laparoscopic ovarian endometriosis cystectomy combined with leuprolide on ovarian reserve function
and fertility.
CHEN Xue-lan, CHEN Guang-yuan, HUANG Ping, YANG Zhi-hong. Department of Gynecology, Shenzhen
Songgang People's Hospital, Shenzhen 518105, Guangdong, CHINA

【Abstract】 Objective To explore the effect of laparoscopic ovarian endometriosis cystectomy combined
with leuprolide on ovarian reserve function and fertility in patients with bilateral ovarian endometriosis cyst (OEM).
Methods Eighty-two patients with bilateral OEM in Department of Gynaecology in Shenzhen Songgang People's Hospi-
tal from January 2013 to January 2015 were divided into observation group (n=41) and control group (n=41) according to
the random number table. The control group was treated with laparoscopic ovarian endometriosis cystectomy, and the ob-
servation group applied leuprolide on the basis of the control group. The levels of sex hormone level, including follicle
stimulating hormone (FSH), estradiol (E2) and luteotropic hormone (LH), were detected by radioimmunoassay. During
the 1 year follow-up, the recurrence rate, pregnancy time and pregnancy rate of the patients were recorded. Results The
levels of FSH, E2 and LH were (8.02±2.08) mIU/mL, (58.52±6.25) pg/mL, (4.62±0.40) mIU/mL in observation group af-
ter treatment, and the control group were (9.89±2.04) mIU/mL, (51.04±5.82) pg/mL, (4.01±0.86) mIU/mL, with statisti-
cal significance difference between the groups (P<0.05); Among the 13 patients with infertility in the observation group,
9 was pregnant after treatment, and among the 15 patients with infertility in the control group, 6 was pregnant after treat-
ment. The pregnancy time (7.32 ± 2.15) months in observation group was significantly shorter than that in the control
group (9.06±1.58) months, with statistically significant differences (P<0.05); After 1 year, the recurrence rate was 4.88%
(2/41)in observation group, which was significantly lower than the control group of 17.07% (7/41), with statistically signif-
icant difference (P<0.05). Conclusion Bilateral OEM of patients were given leuprolide therapy before laparoscopic ovar-
ian endometriosis cystectomy, which can effectively relieve the effect of surgery on ovarian reserve function, improve the
pregnancy rate, and reduce the recurrence rate.

      【Key words】 Endometriosis; Leuprolide; Laparoscopy; Ovarian reserve function; Fertility
·论 著·
6350.2016.16.020