鄭娟 黃曉榮 代學(xué)營(yíng)
[摘要]目的 研究B超引導(dǎo)下經(jīng)陰道行卵巢囊腫穿刺術(shù)治療不孕癥伴卵巢囊腫的臨床效果。方法 選取2017年12月~2018年12月聊城市第四人民醫(yī)院收治的53例不孕癥伴卵巢囊腫患者,經(jīng)隨機(jī)數(shù)字表法分為A組(26例)和B組(27例)。A組進(jìn)行促排卵治療,B組實(shí)施促排卵治療+卵巢囊腫穿刺術(shù),比較兩組促排卵情況、臨床效果、不良反應(yīng)發(fā)生情況。結(jié)果 B組尿促性素(HMG)用量少于A組,B組用藥天數(shù)、卵泡期天數(shù)均短于A組,B組妊娠率高于A組,B組的臨床治療總有效率高于A組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組的感染、盆腔粘連等不良反應(yīng)總發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。結(jié)論 在不孕癥伴卵巢囊腫治療中用B超引導(dǎo)下經(jīng)陰道行卵巢穿刺術(shù),能減少HMG用量,縮短用藥天數(shù)、卵泡期天數(shù),提高妊娠率,臨床效果顯著。
[關(guān)鍵詞]卵巢囊腫穿刺術(shù);不孕癥;卵巢囊腫;尿促性素;卵泡期
[中圖分類(lèi)號(hào)] R737.31? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-4721(2020)7(c)-0113-03
Clinical effect of transvaginal ovarian cyst puncture under the guidance of B-ultrasound in the treatment of infertility with ovarian cyst
ZHENG Juan1? ?HUANG Xiao-rong1? ?DAI Xue-ying2
1. Department of Gynecology and Obstetrics, Liaocheng Fourth People′s Hospital of Shandong Province, Liaocheng? 252000, China; 2. Department of Gynecology and Obstetrics, Liaocheng Dongchangfu Maternal and Child Health Hospital, Shandong Province, Liaocheng? ?252000, China
[Abstract] Objective To study the clinical effect of transvaginal ovarian cyst puncture under the guidance of B ultrasound in the treatment of infertility with ovarian cyst. Methods A total of 53 infertile patients with ovarian cyst were selected treated in the Fourth People′s Hospital of Liaocheng City from December 2017 to December 2018. By random number table method, patients were divided into group A (n=26) and group B (n=27). Group A was treated with ovulation induction, and group B was treated with ovulation induction+puncture of ovarian cyst. Ovulation induction, clinical effect, adverse reaction between two groups were compared. Results The dosage of Urotropin (HMG) in group B was less than that in group A, the days of medication and follicular period in group B were shorter than that in group A, the pregnancy rate in group B was higher than that in group A, the total effective rate of clinical treatment in group B was higher than that in group A, the differences were statistically significant (P<0.05). There was no significant difference between the two groups in the total incidence of adverse reactions such as infection, pelvic adhesion (P>0.05). Conclusion In the treatment of infertility with ovarian cyst, transvaginal ovarian puncture under the guidance of B ultrasound can reduce the dosage of HMG, shorten the days of medication and follicular period, and improve the pregnancy rate. The clinical effect is significant.
綜上所述,將B超引導(dǎo)下經(jīng)卵巢穿刺術(shù)用于不孕癥伴卵巢囊腫治療,臨床效果顯著,患者用藥天數(shù)、卵泡期天數(shù)明顯縮短,HMG用量少,妊娠率高,說(shuō)明這種治療方式可臨床推廣應(yīng)用。而受樣本數(shù)量限制,以至于實(shí)驗(yàn)結(jié)果普遍性有所缺失,未來(lái)將搜集整理更多臨床病例信息,再開(kāi)展臨床研究,得出更科學(xué)、準(zhǔn)確實(shí)驗(yàn)結(jié)論,為后續(xù)同類(lèi)研究工作開(kāi)展提供理論支持。
[參考文獻(xiàn)]
[1]劉鳳翔.經(jīng)陰道B超引導(dǎo)下卵巢囊腫穿刺術(shù)的護(hù)理配合[J].基層醫(yī)學(xué)論壇,2018,22(15):134-135.
[2]陳紅美,邱寧,韓芳.陰道B超引導(dǎo)下卵巢囊腫穿刺的護(hù)理體會(huì)[J].基層醫(yī)學(xué)論壇,2017,21(3):381-382.
[3]劉玉華.經(jīng)陰道穿刺手術(shù)治療卵巢囊腫及對(duì)卵巢功能的應(yīng)用效果[J].中國(guó)繼續(xù)醫(yī)學(xué)教育,2018,10(20):95-96.
[4]黃晶,林也容,李娟,等.經(jīng)陰道與經(jīng)腹行良性卵巢囊腫切除術(shù)的療效比較[J].臨床醫(yī)學(xué)工程,2018,25(12):109-110.
[5]胡滿(mǎn)英,胡火英.經(jīng)陰道彩色多普勒超聲診斷卵巢黃體囊腫破裂的臨床分析[J].當(dāng)代醫(yī)學(xué),2017,23(16):66-68.
[6]楊微微,何秀麗.超聲引導(dǎo)下穿刺活檢在診斷卵巢腫瘤中的應(yīng)用價(jià)值[J].中國(guó)現(xiàn)代醫(yī)學(xué)雜志,2017,27(18):124-126.
[7]黃曉麗,張秀枝.B超引導(dǎo)下介入術(shù)與腹腔鏡微創(chuàng)手術(shù)治療卵巢囊腫的臨床效果比較[J].現(xiàn)代診斷與治療,2019, 30(2):189-191.
[8]董利琴,任默,張建華.卵巢囊腫不同處理方式對(duì)卵巢儲(chǔ)備功能及體外受精-胚胎移植助孕結(jié)局的影響[J].中國(guó)計(jì)劃生育學(xué)雜志,2018,26(9):841-844.
[9]張欣欣,林鳳,鄭飛云.妊娠期發(fā)生附件扭轉(zhuǎn)的高危因素及早期診斷研究[J].醫(yī)學(xué)研究雜志,2018,47(6):135-138.
[10]文剛,諸建明,龔晟,等.經(jīng)臍單部位腹腔鏡輔助下治療新生兒卵巢囊腫的臨床研究[J].中國(guó)現(xiàn)代醫(yī)生,2018,56(2):62-65.
[11]鐘棟高,陳曉穎.B超引導(dǎo)下經(jīng)陰道囊腫穿刺無(wú)水乙醇介入術(shù)和腹腔鏡手術(shù)治療卵巢巧克力囊腫療效觀察[J].泰山醫(yī)學(xué)院學(xué)報(bào),2017,38(11):1282-1283.
[12]管考平,李旭,劉樹(shù)立,等.腹腔鏡輔助經(jīng)臍入路治療小兒卵巢囊腫蒂扭轉(zhuǎn)6例報(bào)告[J].中國(guó)微創(chuàng)外科雜志,2017, 17(11):1050-1052.
[13]張秀麗,黃星球.卵巢囊腫蒂扭轉(zhuǎn)的B超診斷體會(huì)[J].現(xiàn)代診斷與治療,2017,28(18):3456-3458.
[14]薛艷,曾憲玲,岳婷,等.卵巢囊腫蒂扭轉(zhuǎn)在絕經(jīng)后與育齡期患者中的臨床特征比較[J].中國(guó)婦幼健康研究,2016, 27(11):1399-1401.
[15]蘇成芳,朱啟江.介入用無(wú)水乙醇在140例卵巢囊腫穿刺術(shù)中的應(yīng)用療效觀察[J].實(shí)用婦科內(nèi)分泌雜志(電子版),2019,6(19):10-11.
[16]奚宇祥,張敏.評(píng)價(jià)分析在卵巢囊腫治療中在超聲下穿刺介入治療的臨床作用[J].影像研究與醫(yī)學(xué)應(yīng)用,2018, 2(5):106-107.
[17]莊國(guó)麗,尚雪艷,王茹,等.B超引導(dǎo)下經(jīng)陰道行卵巢囊腫穿刺術(shù)治療不孕癥合并卵巢囊腫的療效觀察[J].醫(yī)學(xué)信息,2017,30(8):48-49.
(收稿日期:2019-10-25)
[作者簡(jiǎn)介]鄭娟(1981-),女,山東聊城人,本科,主治醫(yī)師,研究方向:婦產(chǎn)科學(xué)與不孕不育