光动力疗法治疗不孕症患者薄子宫内膜

N. A. Arutyunyan, S. N. Katsalap, A.S. Akatieva, V.F. Khmelevskaya, A. I. Alekhin
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摘要

现在有证据表明子宫内膜的某些结构和功能变化可能是影响生殖系统健康的病因因素。子宫内膜发育不全和子宫血流动力学改变可导致着床失败。由于子宫内膜薄与不孕症、早期流产和治疗困难有关,因此在国内最新技术的基础上,进一步寻找和使用新的治疗方法是有意义的。探讨腔内光动力治疗(PDT)治疗子宫内膜薄的效果。50例年龄为35.4+/-3.3岁,诊断为子宫内膜薄和不孕症的患者被纳入研究。所有患者均给予PDT治疗。治疗前在月经周期II期腔内注射光敏剂“photodiazine”。子宫腔的照射采用波长为660 nm的激光照射医疗器械LAMI。为了使子宫腔内的光均匀分布,使用了宫内圆柱形光纤扩散器(OFD«KOVB-660»)。平均激光功率密度为0.05+/-0.02 W/cm2,能量密度为36.7+/-5.9 J/cm2,激光照射时间为11.7+/-2.25 min。我们发现,使用腔内PDT治疗子宫内膜薄可以纠正月经周期,达到持久的临床效果,再生子宫内膜的厚度和三层结构,增加确认怀孕的百分比,降低妊娠并发症的风险。
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Photodynamic therapy for thin endometrium in patients with infertility
There is now evidence of certain structural and functional changes in the endometrium that may be etiological factors affecting the reproductive system health. Endometrial hypoplasia and alter-ations in uterine hemodynamics may cause implantation failure. Because thin endometrium is associated with infertility, early miscarriage and difficulty of treating, further search and use of new therapeutic methods designed on the basis of domestic state-of-the-art technologies is relevant. Effectiveness of intracavitary photodynamic therapy (PDT) for patients with thin endometrium was investigated. Fifty patients at the age of 35.4+/-3.3 years with established diagnoses of thin endometrium and infertility were included in the study. All patients were given PDT. Before the treatment the photosensitiser “Photoditazine” was injected intracavitary in the II phase of the menstrual cycle. For irradiation of the uterine cavity the medical apparatus “LAMI” providing laser radiation with wavelength of 660 nm, was used. To distribute evenly the light in the uterine cavity, intrauterine cylinder optical fiber diffuser (OFD «KOVB-660») was used. The average laser power density was 0.05+/-0.02 W/cm2, energy density 36.7+/-5.9 J/cm2, laser exposure time 11.7+/-2.25 min. We found that the use of intracavitary PDT for thin endometrium allows to correct the menstrual cycle, to achieve long-lasting clinical effect, to regenerate the thickness and 3-layer structure of the endometrium, to increase the percentage of recognised pregnancies and to reduce the risk of pregnancy complications.
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