【摘要】 目的分析腹腔镜术后联合促性腺激素释放激素(GnRH)对子宫内膜异位症合并不孕患者妊娠结局及婚姻质量的影响。方法选取青岛市市立医院自2014年6月至2015年6月收治的110例子宫内膜异位症合并不孕患者,采取随机数字表法分为对照组与观察组,每组各55例,对照组仅给予单纯腹腔镜治疗,观察组给予腹腔镜联合GnRH-α治疗,对比两组患者术后试孕12个月自然妊娠率、流产率、异位妊娠率、早产率、足月产率等妊娠结局,同时对比两组患者术后随访12个月期间的婚姻质量。结果观察组与对照组相比,术后试孕12个月累计妊娠率及足月产率高,流产率、异位妊娠率及早产率低,差异均具有统计学意义(χ2值分别为7.89、9.98、6.76、6.41、6.76,均P<0.05)。与治疗前相比,两组治疗后的过分理想化、婚姻满意度、夫妻交流、性格相容性、解决冲突、经济安排、业余活动、子女和婚姻、与亲友关系、角色平等性、信仰一致性及性生活评分均明显升高,但观察组比对照组改善更加显著,均具有统计学意义(t值为6.45~7.66,均P<0.05)。结论腹腔镜术后联合GnRH-α治疗子宫内膜异位症合并不孕患者的疗效明显优于单独使用腹腔镜者,可获得更高的妊娠率,改善妊娠结局,提高婚姻质量。更多还原

【Abstract】 Objective To analyze the influence of laparoscopic surgery combined with gonadotropin-releasing hormone agonist( GnRH-α)on pregnancy outcomes and marital quality of endometriosis associated infertility patients. Methods Altogether 110 endometriosis associated infertility cases treated in Qingdao Municipal Hospital from June 2014 to June 2015 were selected and divided into observation group and control group according to random number table with 55 cases in each group. Patients in the control group were only treated with pure laparoscopic surgery,while patients in the observation group were given laparoscopic surgery combined with GnRN-α treatment. Pregnancy outcomes of patients in two groups,such as natural pregnancy rate,miscarriage rate,ectopic pregnancy rate,premature birth rate,fullterm production rate in 12 months after surgery were compared. At the same time,marriage quality of patients in two groups in 12 months of postoperative follow-up was compared. Results Compared to the control group,cumulative pregnancy rate and full-term pregnancy rate were higher,and miscarriage rate,ectopic pregnancy rate and premature birth rate were lower in the observation group in 12 months after surgery. The differences were statistically significant( χ2value was 7. 89,9. 98,6. 76,6. 41 and 6. 76,respectively,all P < 0. 05).Scores of excessive idealization, marital satisfaction, couples exchange, character compatibility, conflict resolution, economic arrangements,leisure activities,children and marriage status,relationship with friends and family,role equality,belief consistency and sexual life increased obviously in two groups after treatment compared to those before treatment,but the improvement in the observation group was more remarkable than that in the control group with statistically significant difference( t value ranged 6. 45 to 7. 66,all P <0. 05). Conclusion Efficacy of laparoscopic surgery combined with GnRH-α treatment for endometriosis associated infertility patients is better compared to single usage of laparoscopic surgery. The former can obtain higher pregnancy rate,improve pregnancy outcomes and improve quality of marriage.更多还原