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[子宫内膜异位症患者输卵管性不孕的治疗细节]

[Specifics of therapy of tubal infertility in patients with endometriosis].

作者信息

Vegheş Simina, Lupaşcu Ivona, David Cristina, Vişan Valeria, Vasiliu Veronica

机构信息

Univesitatea de Medicină şi Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină, Clinica a II-a Obstetrică-Ginecologie.

出版信息

Rev Med Chir Soc Med Nat Iasi. 2005 Jul-Sep;109(3):542-7.

Abstract

Our purpose was to define the best way of treating tubal infertility caused by endometriosis. We have studied 24 patients with tubal infertility caused by endometriosis; the etiology has been laparoscopically established in the 2nd Clinic of Obstetrics and Gynecology Iaşi. The endometriosis score (r-AFS) was used to establish the therapy. We performed laparoscopic treatment when endometriosis was visible. Postoperative medical therapy (Diphereline, 3 months) was indicated; patients with ,,unpigmented endometriosis" received the same medical therapy. The rate of pregnancies in patients that had benefit of combined therapy: surgical and medical (n=9) was superior (44.4%) to that obtained in patients that were only surgical treated (n=15): 26.6% (Spearman correlation--0.6595, p < 0.0012). Endometriosis is an important etiological factor in female infertility. The pathway is mechanic as well as chemical and it justifies the combined therapy. There are better results, as fertility prognosis in patients with endometriosis that receive both, surgical and medical therapy.

摘要

我们的目的是确定治疗由子宫内膜异位症引起的输卵管性不孕的最佳方法。我们研究了24例由子宫内膜异位症引起的输卵管性不孕患者;病因已在雅西第一妇产科诊所通过腹腔镜检查确定。采用子宫内膜异位症评分(r-AFS)来确定治疗方案。当可见子宫内膜异位症时,我们进行了腹腔镜治疗。术后给予药物治疗(达菲林,3个月);“无色素沉着型子宫内膜异位症”患者接受相同的药物治疗。接受手术和药物联合治疗的患者(n = 9)的妊娠率为44.4%,高于仅接受手术治疗的患者(n = 15)的妊娠率26.6%(Spearman相关性——0.6595,p < 0.0012)。子宫内膜异位症是女性不孕的一个重要病因。其途径包括机械性、化学性,这也说明了联合治疗的合理性。对于接受手术和药物联合治疗的子宫内膜异位症患者,生育预后有更好的结果。

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