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目的探讨囊肿核摘除术联合促性腺激素释放激素激动剂(GnHR-a)对卵巢囊肿患者卵巢储备功能及妊娠结果的影响。方法选取2013年7月至2015年7月间临朐县人民医院收治的120例卵巢囊肿患者,按照是否接受手术联合治疗分为观察组和对照组,每组60例。再将两组患者按照手术类型分为双侧囊肿核摘除术组与单侧囊肿核摘除术组,每组各30例。对比各组窦卵泡数、GnRHa天数、促性腺激素(Gn)支数、人绒毛膜促性腺激素(HCG)注射日E_2、卵泡数、卵子数、好胚数、冷冻数、移植数、妊娠率、流产率、分娩率和着床率。结果双侧囊肿核摘除对照组与双侧囊肿摘除观察组相比,窦卵泡数减少、Gn支数增加、HCG注射日E_2水平降低、卵泡数、卵子数、好胚数、冷冻数、移植数均减少,差异均有统计学意义(均P<0.05)。双侧囊肿核摘除对照组与双侧囊肿摘除观察组妊娠率、流产率和分娩率比较,差异无统计学意义(P>0.05)。单侧囊肿核摘除联合GnHR-a治疗观察组与单侧囊肿核摘除对照组比较,窦卵泡数减少、Cn支数增加、卵泡数减少、卵子数减少,差异有统计学意义(P<0.05)。单侧囊肿核摘除联合GnHR-a治疗观察组与单侧囊肿摘除对照组比较,HCG注射日E_2水平、好胚数、冷冻数、移植数、妊娠率、流产率、分娩率的差异均无统计学意义(均P>0.05)。结论单侧或双侧囊肿核摘除术均可对患者的卵巢储备功能造成影响,联合GnHR-a治疗可明显改善生殖功能下降情况,且不影响生育能力,应引起临床工作者的重视。
Objective To investigate the effects of cystuclear neucleotomy combined with gonadotropin-releasing hormone agonist (GnHR-a) on ovarian reserve and pregnancy outcomes in patients with ovarian cysts. Methods A total of 120 patients with ovarian cysts admitted to Linqu County People’s Hospital from July 2013 to July 2015 were divided into observation group and control group according to whether they were treated by surgery or not, with 60 cases in each group. The two groups of patients were divided into bilateral cyst excision group and unilateral cyst nuclear excision group according to the operation type, 30 cases in each group. The number of antral follicles, GnRHa days, gonadotrophin (Gn) count, E_2 of human chorionic gonadotropin (HCG) injection day, number of follicles, number of eggs, number of good embryos, number of frozen, number of transplants, pregnancy rate , Abortion rate, delivery rate and implantation rate. Results The numbers of antral follicles, Gn counts and E_2 levels on the day of HCG injection decreased compared with those in the bilateral cyst excision control group. The number of follicles, the number of eggs, the number of embryos, the number of frozen, the number of transplants All decreased, the differences were statistically significant (both P <0.05). There were no significant differences in pregnancy rate, abortion rate and delivery rate between bilateral cyst excision control group and bilateral cyst excision observation group (P> 0.05). The number of antral follicles, the number of Cn, the number of follicles and the number of ovum decreased in unilateral cystucleus retroflexus combined with GnHR-a treatment group were significantly lower than those in unilateral cyst nucleus excision control group (P <0.05) . Unilateral cystucleus neucleotransplantation combined with GnHR-a treatment group and unilateral cyst excision control group, HCG injection E_2 level, good embryo number, number of frozen, number of transplantation, pregnancy rate, abortion rate, delivery rate differences were not statistically Significance (both P> 0.05). Conclusion Unilateral or bilateral cystucleotomy can affect the ovarian reserve in patients with GnHR-a treatment can significantly reduce the decline of reproductive function, and does not affect fertility, should arouse the attention of clinicians.