摘要
目的探讨AMH评估手术联合Gnrh-a治疗双侧卵巢子宫内膜异位症卵巢功能恢复情况。方法共33例双侧卵巢子宫内膜异位症患者,行术前至术后至少一年的临床跟踪研究,手术方式选择腹腔镜下卵巢囊肿剥除术,缝合止血,术前检测AMH及卵巢激素(FSH,LH,E2);术后1月复查AMH;术后3月复查AMH、卵巢激素;术后6月复查AMH;术后9月,12月于月经来潮第3天复查AMH、卵巢激素,记录月经性状。结果术后AMH指标呈一过性下降,并逐渐恢复至术前水平;术后9月至12月随访时月经性状异常者有8例(月经性状异常组),其余25例无异常(月经性状正常组),术后6月,12月AMH值在两组病例中表现的差异有统计学意义(P<0.05),术后12月的E2、FSH/LH水平,两组病例数据有统计学差异(P<0.05);妊娠病例5例(妊娠组),其余28例尚未妊娠(尚未妊娠组),两组术后6月的AMH数值差异有显著的统计学意义(P<0.01)。结论手术联合Gnrh-a治疗双侧卵巢子宫内膜异位症时,术后AMH比卵巢激素可以更早的发现卵巢功能降低的患者,术后6月AMH即可作为评估卵巢功能恢复情况的指标。
Objective To explore the assessment of the ovarian function recovery by using AMH,in which bilateral ovarian endometriosis was treated by surgery combined with Gnrh- a. Methods A total of 33patients with bilateral ovarian endometriosis were included,following-up from before surgery to at least one year after operation. Select surgical laparoscopic ovarian cystectomy and hemostasis. Detected AMH and ovarian hormones（ FSH,LH,E2） before surgery,reviewed AMH 1 month after surgery,reviewed AMH and ovarian hormones 3 months after operation,reviewed AMH 6 months later,reviewed AMH and ovarian hormones 3 days ahead of menstrual onset at 9th months and 12 th months, and recorded menstrual characters. Results Postoperative AMH indicators showed a transient decrease,and gradually returned to the preoperative level. After9 to 12 months period of follow-up,8 patients with abnormal menstrual characters,the other 25 patients without exception. AMH level showed that the differences with statistical significance between the above two groups after 6and 12 months（ P〈0. 05）. E2 and FSH / LH level with statistical significance between the above two groups after12 months（ P〈0. 05）. 5 patients got pregnancy,and the remaining 28 patients not got pregnancy yet. 6 months after treatment,AMH showed statistical significance differences between the two groups（ P〈0. 01）. Conclusions In the treatment of bilateral ovarian endometriosis by surgery combined with Gnrh-a,the detection of AMH can earlier discover the patients with ovarian function decrease comparing to ovarian hormones,6 months after the surgery AMH level can be used as a predictive indicator for ovarian function recovery.
出处
《齐齐哈尔医学院学报》
2016年第25期3137-3140,共4页
Journal of Qiqihar Medical University
