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目的探讨子宫内膜异位症伴不孕患者腹腔镜手术联合促性腺激素释放激素激动剂(GnRH-α)治疗后的自然妊娠率及妊娠结局。方法将子宫内膜异位症伴不孕患者256例,随机分为单纯腹腔镜手术组127例(A组),腹腔镜联合GnRH-α组129例(B组),术后电话随访12~28个月,对两组患者术后试孕6个月、12个月的累计自然妊娠率及自然流产、宫外孕、早产、足月活产率等妊娠结局进行分析。结果最终纳入患者229例。A、B两组患者术后试孕12个月的累积妊娠率分别是52.7%(58/110)与69.7%(83/119),差异有统计学意义(P<0.05)。A、B两组患者之间自然流产率、宫外孕率、早产率、足月活产率差异无统计学意义(P>0.05)。结论腹腔镜术后联合GnRH-α治疗较单纯腹腔镜手术治疗对提高子宫内膜异位症不孕患者的妊娠率有更好的效果。
Objective To investigate the natural pregnancy rate and pregnancy outcome after laparoscopic surgery combined with gonadotropin-releasing hormone agonist (GnRH-α) in patients with endometriosis and infertility. Methods 256 patients with endometriosis and infertility were randomly divided into simple laparoscopic surgery group (127 cases), laparoscopic combined with GnRH - α group (129 cases), group B 28 months, the two groups of patients after pregnancy test 6 months, 12 months of cumulative natural pregnancy rate and spontaneous abortion, ectopic pregnancy, premature birth, full-term live birth rate and other pregnancy outcomes were analyzed. The final result was included in 229 patients. The cumulative pregnancy rates of 12 and 12 months after operation in patients A and B were 52.7% (58/110) and 69.7% (83/119), respectively, with significant difference (P <0.05). There was no significant difference in spontaneous abortion rate, ectopic pregnancy rate, premature birth rate and full-term live birth rate between A and B groups (P> 0.05). Conclusions Laparoscopic surgery combined with GnRH-α has a better effect than pregnancy-only laparoscopic surgery on pregnancy rate in patients with endometriosis and infertility.