摘要
目的探讨影响子宫内膜异位症(EMT)不孕患者行宫-腹腔镜双镜术后妊娠的相关因素。方法收集2011年2月至2015年4月于该院行宫-腹腔镜联合治疗的240例EMT不孕患者的临床资料,按是否妊娠分为妊娠组与未妊娠组,比较两组临床资料、病理资料及术后治疗情况的差异,采用单因素及多因素非条件Logistic回归分析筛选EMT不孕患者双镜术后妊娠的影响因素。结果 (1)240例患者术后妊娠142例,妊娠率为59.17%;(2)妊娠组年龄小于35岁、不孕年限小于3年、继发性不孕、腹膜型EMT、输卵管功能正常、术后排卵治疗所占比例均高于未妊娠组,其合并子宫腺肌病、有腹部手术史所占比例、临床分期均低于未妊娠组(P<0.05);(3)多因素分析显示:年龄、不孕时间、不孕类型、合并子宫腺肌病、临床分期、输卵管功能为影响EMT不孕患者术后妊娠的独立危险因素,病理分期为其保护因素。结论年龄越大、不孕年限越长、临床分期越高且合并子宫腺肌病的EMT不孕患者宫-腹腔镜术后妊娠率越低,而腹膜型EMT不孕患者术后妊娠结局较好。
Objective To investigate the related factors for pregnancy after hysteroscopic and laparoscopic surgery in infertile patients with endometriosis(EMT).Methods The clinical data of 240 infertile patients with EMT treated in this hospital from February 2011 to April 2015 were collected.According to whether the subjects were pregnant,the patients were divided into the pregnancy group and the non-pregnancy group.The differences in clinical data,pathological data and postoperative treatment were compared between the two groups.The univariate and multivariate non-conditional Logistic regression analyses were performed to analyze and screen the factors influencing pregnancy after hysteroscopic and laparoscopic surgery in infertile patients with EMT.Results(1)Among 240 cases,there were 142 cases of postoperative pregnancy with the pregnancy rate of 59.17%.(2)The proportions of age<35 years old,duration of infertility<3 years,secondary infertility,peritoneal type EMT,normal fallopian tube function and ovulation therapy after surgery in the pregnancy group were higher than those in the-non pregnancy group,and the proportion of complicating adenomyosis,having abdominal surgery history and clinical stage were lower than those in the non-pregnancy group(P<0.05).(3)The multivariate analysis showed that age,duration of infertility,type of infertility,complicating adenomyosis,clinical stage and fallopian tube function were the independent risk factors affecting postoperative pregnancy in infertile patients with EMT,and the pathological stage was its protective factor.Conclusion The EMT infertile patients with older age,longer infertility duration,higher clinical stage and complicating adenomyosis have the lower postoperative pregnant rate,while infertile patients with peritoneal type EMT have better postoperative pregnant outcome.
作者
赵宁
雷勇
ZHAO Ning;LEI Yong(Department of Gynecology,Halison International Peace Hospital,Hengshui,Hebei 053000,China;First Department of General Surgery,Halison International Peace Hospital,Hengshui,Hebei 053000,China)
出处
《重庆医学》
CAS
2018年第27期3517-3520,共4页
Chongqing medicine
关键词
子宫内膜异位症
不孕
宫-腹腔镜
妊娠
endometriosis
infertility
hysteroscopy and laparoscopy
pregnancy
