探讨促性腺激素释放激素激动剂不同给药时机对巧克力囊肿剥除术患者自然妊娠率的影响

目的:探究与分析促性腺激素释放激素激动剂(GnRH-a)不同给药时机对巧克力囊肿(OCC)剥除术患者自然妊娠率的影响。方法:回顾性分析2018年5月至2019年5月滨州市中心医院妇科收治的110例女性OCC剥除术患者的临床资料，年龄(30.45±2.44)岁，年龄范围为25～34岁。按照GnRH-a不同给药时机分为术前...

Effect of gonadotropin-releasing hormone agonist administration at different times on the natural pregnancy rate of patients undergoing ovarian chocolate cyst exfoliation

Objective To investigate and analyze the effect of gonadotropin-releasing hormone agonist(GnRH-a)administered at different times on the natural pregnancy rate of patients undergoing ovarian chocolate cyst(OCC)exfoliation.Methods A retrospective study was performed on 110 cases of patients with OCC were admitted to the department of Gynecology,Binzhou Central Hospital and underwent OCC exfoliation from May 2018 to May 2019,aged(30.45±2.44)years old,ranging 25 to 34 years old.According to GnRH-a different administration times,patients were divided into the preoperative group(n=61)and postoperative group(n=49).Patients in the preoperative group were given Diphereline before surgery,and patients in the postoperative group were given Diphereline after surgery.The perioperative indexes,clinical treatment effects,sex hormone levels[follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol]before and after treatment,and natural pregnancy rate of 1 year follow-up were compared between the two groups.Results The operative time[(76.24±14.08)minutes],postoperative exhaust time[(19.32±3.81)hours],intraoperative blood loss[(45.89±8.30)ml]and abdominal drainage fluid volume[(53.23±8.12)ml]in the preoperative group were all lower than those in the postoperative group[(104.97±19.36)minutes,(22.78±4.21)hours,(60.52±12.44)ml and(60.85±11.34)ml];the complication rate[1.6%(1/61)]in the preoperative group was lower than that in the postoperative group[14.3%(7/61)],and all the differences were statistically significant(P<0.05).The total clinical effective rate in preoperative group[96.7%(59/61)]and 1-year follow-up rate of natural pregnancy[73.8%(45/61)]were higher than those in the postoperative group[85.7%(42/49)and 55.1%(27/49)],and the difference was statistically significant(P<0.05).After treatment,the levels of FSH[(3.28±1.41)IU/L,(5.09±1.53)IU/L],LH[(1.20±0.52)IU/L,(1.40±0.37)IU/L]and estradiol[(32.87±18.34)pg/ml and(41.78±22.53)pg/ml]in both groups were lower than those before treatment[(6.63±2.60)IU/L,(6.60±2.57)IU/L,(1.49±0.75)IU/L,(1.50±0.73)IU/L,(62.20±20.47)pg/ml and(61.04±24.13)pg/ml],the levels of FSH and estradiol in the postoperative group were higher than those in the preoperative group,and all the differences were statistically significant(P<0.05).Conclusion Pretreatment Diphereline was used in OCC exfoliation patients with better perioperative performance,significant therapeutic effect and higher natural pregnancy rate.Future studies can further expand the sample size analysis and explore the clinical advantages of preoperative use of Diphereline.