刘小山,陈志芳,刘新莲,杜蓉,丁岩

• 1:新疆医科大学第一附属医院妇科

摘要(Abstract)：

目的探讨药物对维吾尔族卵巢子宫内膜异位囊肿(OEM)患者术后卵巢功能的保护作用。方法选择维吾尔族OEM患者157例为研究对象,随机分为A、B、C、D 4组。4组患者均行腹腔镜下OEM剥除术。A组:患者术后口服米非司酮3个月。B组:患者术后肌注达菲林3个月。C组:患者术前给予达菲林肌注2个月,术后继续给予达菲林肌注3个月。D组:患者术前、术后均不使用任何药物。术后随访12个月,比较4组患者的临床疗效、妊娠情况及用药前后体内的激素水平、窦卵泡计数(AFC)与骨密度的变化。结果 (1)C组患者临床有效率明显高于其他3组(P<0.05),A、B组有效率高于D组(P<0.05)。C组患者的无效率最低,A组患者的无效率最高,C组与A组无效率差异有统计学意义(P=0.016)。D组患者复发率最高,C组患者复发率最低,A、B、C组复发率均低于D组(P<0.05)。(2)C组患者妊娠率(68.4%)最高,D组妊娠率最低(5.8%)。B、C组与D组比较差异有统计学意义(P<0.05)。(3)各组患者在用药前体内雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)水平及AFC差异无统计学意义(P>0.05),D组患者术后12个月AFC较术前明显下降,差异有统计学意义(P=0.047)。A组患者术后3个月E2明显下降,差异有统计学意义(P=0.045),停药后渐渐恢复至术前水平。B组和C组患者术后3、6个月体内E2、FSH、LH较用药前明显下降(P<0.05),C组患者术后3个月的E2低于B组患者术后3个月的E2,且差异有统计学意义(P=0.038)。B组和C组患者的AFC在术后3个月较用药前明显下降(P<0.05),停药后渐渐恢复,术后9、12个月较用药前均明显上升,差异有统计学意义(P<0.05)。术后12个月时C组患者AFC高于B组患者,差异有统计学意义(P=0.044)。(4)各组患者在用药前骨密度无明显差异(P>0.05)。B组和C组患者用药后6、12个月较用药前骨密度明显下降,差异有统计学意义(P<0.05)。但在用药后6个月,C组患者的骨密度高于B组,两组差异有统计学意义(P<0.05)。结论 OEM患者术后卵巢功能有一定损伤。术前术后联合使用达菲林可以更好的保护EMS患者卵巢功能。

关键词(KeyWords)： 维吾尔族;卵巢子宫内膜异位囊肿;卵巢保护

Abstract:

Keywords:

基金项目(Foundation): 新疆维吾尔自治区自然科学基金(2012211A066)

作者(Author): 刘小山,陈志芳,刘新莲,杜蓉,丁岩

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