摘要
目的:探究腹腔镜治疗子宫内膜异位症(EMT)的疗效及妊娠预后影响因素分析。方法:选取EMT合并不孕患者60例为研究对象,所有研究对象均行腹腔镜手术,观察手术疗效和并发症,同时对患者年龄、不孕时间、不孕类型、r-AFS分期、病理分型、术后是否规律用药及是否接受辅助生殖等临床因素与妊娠预后相关性进行分析。结果:60例患者术后均未出现并发症。随访3个月22例痊愈,38例有效,治疗有效率为100.0%。术后2年累积妊娠45例,妊娠率为75.0%,术后1年内的妊娠率(56.7%)明显高于术后1~2年的妊娠率(18.3%),差异有统计学意义(χ2=9.34,P=0.007);妊娠组与非妊娠组患者在年龄、是否合并子宫腺肌病、术后是否规范用药、术后是否接受辅助生殖技术方面的差异有统计学意义(P<0.05);而在不孕时间、不孕类型、r-AFS分期和病理类型的差异无统计学意义(P>0.05)。Logistic回归分析显示,年龄(≥35岁)、合并子宫腺肌病、术后未规律用药、术后未采取辅助生殖技术是EMT腹腔镜妊娠预后独立性危险因素(P<0.05)。结论:腹腔镜手术治疗EMT安全有效,可提高妊娠率;年龄(≥35岁)、合并子宫腺肌病、术后未规律用药、术后未采取辅助生殖技术是EMT腹腔镜妊娠预后独立性危险因素;EMT患者腹腔镜术后规律用药,联合辅助生殖技术可能为提高妊娠几率最理想的方法。
Objective: To investigate the efficacy of laparoscopic treatment of endometriosis and analysis the factors affecting pregnancy prognosis. Methods: 60 cases of EMT with infertility were selected as the research object,underwent laparoscopic surgery,and observed the curative effect and complications. At the same time,the correlation of clinical factors such as age,infertile time,infertility type,r-AFS staging,pathological classification,the regular use of medication after operation and whether to accept auxiliary reproduction and the prognosis of pregnancy was analyzed. Results: There were no complications in 60 patients. After 3 months of follow-up,22 cases were cured,38 cases were effective,and the effective rate was 100%. The cumulative pregnancy was 45 cases after 2 years,and the pregnancy rate was 75%. The rate of pregnancy within 1 years( 56. 7%) was significantly higher than that of the 1 ~ 2 year after operation( 18. 3%),the difference was statistically significant( χ^2= 9. 34,P = 0. 007). There were significant differences in age,whether amalgamative adenomyosis,whether the regular use of medication after operation and whether to accept auxiliary reproduction in the pregnancy group and non pregnancy group( P〈0. 05),but there was no significant difference in infertility time,infertility type,r-AFS stage and pathological type( P〈0. 05). Logistic regression analysis that age( over 35 years),adenomyosis,patients without regular medication,without auxiliary reproduction after operation were risk factors for independent prognosis of EMT laparoscopic pregnancy( P〈0. 05). Conclusion: Laparoscopic surgery is safe and effective for the treatment of EMT,can improve the pregnancy rate; age( over 35 years),adenomyosis,patients without regular medication,without auxiliary reproduction after operation are risk factors for independent prognosis of EMT laparoscopic pregnancy,regular medication after laparoscopic surgery,assisted reproductive technology may be the best way to
作者
巫小燕
WU Xiao-yan(Department of Obstetrics and Gynecology, Chizhou People's Hospital, Chizhou 247000 ,Anhui , Chin)
出处
《川北医学院学报》
CAS
2018年第2期217-219,共3页
Journal of North Sichuan Medical College
基金
安徽省池州市2012年底科技计划(医药卫生类14)
关键词
腹腔镜治疗
子宫内膜异位
妊娠预后
因素
Laparoseopie treatment
Endometriosis
Pregnancy prognosis
Factors