摘要
目的探讨子宫腺肌病(adenomyosis,AM)合并子宫内膜异位症(endometriosis,EMT)不孕患者的手术疗效及其影响因素。方法回顾性分析2014年1月至2018年12月于陆军军医大学第一附属医院行姑息性手术治疗的99例AM合并EMT不孕患者的临床资料,根据术后1年内是否妊娠,将入选患者分为妊娠组和非妊娠组,比较两组患者的临床资料,采用多因素Logistic回归分析探讨AM合并EMT不孕患者术后妊娠的影响因素。结果全部患者术后1年内共有18例(18.2%)妊娠,将其纳入妊娠组,其余81例未妊娠者纳入未妊娠组。妊娠组患者年龄显著小于非妊娠组(P<0.05),不孕时间显著短于非妊娠组(P<0.05),痛经视觉模拟评分法评分、AM类型为弥漫型、美国生育学会提出的修正子宫内膜异位症分期(revised classification of American Fertility Association,r-AFS)Ⅲ~Ⅳ期占比、术中出血量均显著低于非妊娠组(均P<0.05),子宫内膜异位症生育指数(endometriosis fertility index,EFI)评分、术后窦卵泡计数(antral follicle count,AFC)、术后辅助生育占比均显著高于非妊娠组(均P<0.05)。妊娠组术后仅1例(5.6%)患者发热,非妊娠组8例(9.9%)患者术后发生并发症,包括5例发热,3例贫血,均未发生严重并发症,无围手术期死亡,两组患者术后并发症发生率比较差异无统计学意义(P>0.05)。多因素Logistic回归分析结果表明:r-AFS分期、EFI评分、术后AFC均为AM合并EMT不孕患者术后妊娠的独立影响因素(均P<0.05)。结论AM合并EMT不孕患者的手术疗效不甚满意,术后1年内成功妊娠者不足1/5,r-AFS分期、EFI评分、术后AFC均为此类患者术后妊娠的独立影响因素。
Objective To analyze the operative effect and influencing factors of patients with adenomyosis(AM)combined with endometriosis(EMT)and infertility.Method The clinical data of 99 patients with AM combined with EMT and infertility who underwent palliative surgery from January 2014 to December 2018 in the First Affiliated Hospital of Army Military Medical University were analyzed retrospectively.They were divided into pregnancy group and non-pregnancy group according to whether there was pregnancy within 1 year after operation.The clinical data were compared between the two groups,and the influencing factors of postoperative pregnancy in patients with AM combined with EMT and infertility were analyzed by multivariate Logistic regression analysis.Result A total of 18 patients(18.2%)who were pregnant within 1 year after operation were included in pregnancy group,and the remaining 81 cases who were not pregnant were included in non-pregnancy group.Patients in pregnancy group were significantly younger than those in non-pregnancy group(P<0.05),and the duration of infertility was significantly shorter than that in non-pregnancy group(P<0.05),the visual analogue scale score of dysmenorrhea,the type of AM diffuse,the proportion of stageⅢ~Ⅳof revised classification of American Fertility Association(r-AFS),and the intraoperative bleeding were all significantly lower than those in non-pregnancy group(all P<0.05),the endometriosis fertility index(EFI)score,postoperative antral follicle count(AFC),and the proportion of postoperative assisted reproduction were all significantly higher than those in nonpregnancy group(all P<0.05).Only 1 patient(5.6%)in pregnancy group developed fever after operation,while 8 patients(9.9%)in non-pregnancy group developed postoperative complications,including 5 cases of fever and 3 cases of anemia,without serious complications.There was no perioperative death in both groups.There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Multivar
作者
冷少华
王延洲
陈宗涛
Leng Shaohua;Wang Yanzhou;Chen Zongtao(Department of Health Management Center,the First Affiliated Hospital of Army Military Medical University,Chongqing 400038,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of Army Military Medical University,Chongqing 400038,China)
出处
《中国医学前沿杂志（电子版）》
2021年第9期89-93,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
