تأثیر جراحی اندومتریوما با سایز 4 سانتی‌متر و بزرگ‌تر بر میزان بارداری زنان نازا: کارآزمایی بالینی تصادفی شده

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

2 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

3 استاد گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

4 استادیار گروه آمار و اپیدمیولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

5 رزیدنت گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

چکیده

مقدمه: اندومتریوز از شایع‌ترین بیماری­های مزمن زنان است که می­تواند باعث بروز نازایی گردد. برداشتن اندومتریوما از طریق جراحی می­تواند باعث کاهش درد و بهبود کیفیت زندگی بیماران گردد، در حالی که تأثیر آن بر روی باروری هنوز بحث‌برانگیز است، مطالعه حاضر با هدف تعیین تأثیر جراحی اندومتریوما بر پیامد و میزان باروری در زنان مبتلا به اندومتریوما انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی شاهددار تصادفی شده در سال 1396 بر روی 64 زن مبتلا به اندومتریومای بزرگ‌تر از 4 سانتی‌متر که از نازایی شکایت داشتند، انجام شد. پس از تخصیص تصادفی، گروه مداخله جراحی اندومتریوما شدند و گروه کنترل نیز درمان انتظاری را دریافت نمودند و به مدت 6 ماه از نظر باروری تحت پیگیری قرار گرفتند. گردآوری داده­ها با استفاده از چک‌لیست پژوهشگر ساخته انجام شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 20) و آزمون­های تی مستقل و کای دو انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: فراوانی وقوع حاملگی در گروه مداخله (6/76%) با گروه کنترل (6/46%) اختلاف آماری معنی‌داری داشت (023/0=p). همچنین فراوانی حاملگی خود‌به‌خود نیز در دو گروه مداخله و کنترل تفاوت آماری معنی‌داری داشت (22 نفر (7/95%) در برابر 6 نفر (9/42%)) (001/0=p).
نتیجه‌گیری: جراحی اندومتریومای بزرگ‌تر و مساوی 4 سانتی‌متر در زنان نابارور مؤثر می­باشد و امکان بارداری خود‌به‌خودی بدون انجام سایر درمان‌های نازایی را افزایش می­دهد.

کلیدواژه‌ها


عنوان مقاله [English]

Effect of Surgery of Endometrioma≥4 Cm on Fertility Rate and Pregnancy Outcome in women with infertility: A Randomized Clinical Trial

نویسندگان [English]

  • Fariba Seyedoshohadaei 1
  • Masoumeh Rezaie 2
  • Sholeh Shahgheibi 3
  • Nasrin Soufizadeh 2
  • Farnaz Zandvakili 2
  • Dayem Roshani 4
  • Maryam Ghorbanian 5
1 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
2 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
3 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
4 Assistant Professor, Department of Biostatistics and Epidemiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
5 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
چکیده [English]

Introduction: Endometriosis is one of the most common chronic diseases in women that can cause infertility. Surgical removal of endometrioma can reduce pain and improve the quality of life of patients, while its effect on fertility is still controversial. This study was performed with aim to evaluate the effect of endometriosis surgery on fertility rate and outcomes in women with endometrioma.                                               
Methods: This randomized controlled clinical trial was performed in 2017 on 64 women with endometrioma ≥ 4 cm. After random allocation, the intervention group received endometrioma surgery and the control group received expectant treatment. The two groups were followed for six months in terms of fertility. Data were collected using a researcher-made checklist. Data were analyzed by SPSS software (version 20) and independent t-test and Chi-square test. p < 0.05 was considered statistically significant                                                                    
Results: Frequency of pregnancy in the intervention group (76.6%) was significantly different from the control group (46.6%) (p =0.023). Also, the frequency of spontaneous pregnancy was significantly different in the intervention and control groups (95.7%, N=22 vs. 42.9%, N=6) (P=0.001).
Conclusion: Surgery of endometrium ≥4 cm is effective in infertile women and increases the chance of spontaneous pregnancy without other infertility treatments.

کلیدواژه‌ها [English]

  • Endometriosis
  • Endometrioma
  • Infertility
  • Outcome
  • pregnancy
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