摘要
目的:探讨宫-腹腔镜联合治疗子宫内膜异位症(EMT)合并不孕患者术后妊娠的影响因素。方法:选择2012年4月至2014年4月于厦门市妇幼保健院行宫-腹腔镜联合治疗的EMT合并不孕患者共340例为研究对象,随访18~42月,分析影响术后妊娠率的临床因素。结果:292例完成随访,随访率85.88%(292/340),术后妊娠165例(56.51%)。其中术后1~6月、7~12月、13~24月、25~42月分别妊娠115例(39.38%)、40例(13.70%)、8例(2.74%)、2例(0.68%),差异有统计学意义(χ~2=11.76,P<0.05)。多因素分析结果显示:年龄≥35岁、不孕年限≥3年、r-AFS分期高是影响患者术后妊娠的独立危险因素(OR=10.45、3.03、3.74,P<0.05);继发不孕、使用促排卵治疗是影响术后妊娠的独立保护因素(OR=0.23、0.33,P<0.05)。结论:EMT合并不孕患者采用宫-腹腔镜联合治疗可获得较好的术后妊娠率,术后1年内是妊娠最佳时机。患者年龄≥35岁,不孕年限≥3年,r-AFS分期高可影响术后妊娠率,使用促排卵药物治疗对提高妊娠率有益。
Objective：To analyze the influence factors of postoperative pregnancy in patients of endometriosis associated infertility after laparoscopy combined with hysteroscopy treatment. Methods：340 patients with endometriosis associated infertility who underwent laparoscopy combined with hysteroscopy treatment in Maternal and Child Health Care Hospital of Xiamen from April in 2012 to April in 2014 were followed up for 18 -42 months to assess fertility outcomes. The relative factors of postoperative pregnancy rate were analyzed, Results： 85.88% （292/340） of patients were followed up,and the overall postoperative pregnancy rate was 56.51%. Among which the postoperative pregnancy caseswere 115 cases （ 39.38% ）, 40 cases （ 13.70% ）, 8 cases （2.74%）, 2 cases （0.68%） in the 1 - 6 months,7 - 12 months, 13 - 24 months ,25 - 42 months, respectively. There were significant differences among the four groups（χ 2 = 11.76, P 〈 0.05）. The multy-factors analysis showed that age ≥35, infertility time 〉13 ,r-AFS stage relatively high were risk factors of postoperative pregnancy（ OR = 10.45,3.03,3. 74, P 〈 0.05）, and secondary infertility, applying ovarian stimulation treatment were the protective factors of postoperative pregnancy（ OFt = 0.23,0.33, P 〈 0.05 ）. Conclusions： Laparoscopy combined with hysteroscopy treatment can increase postoperative pregnancy rate, and the best time to pregnancy is the first one year after treatment. The age ≥35,infertility time≥3, r-AFS stage relatively high are the important causes for the postoperative infertility,while applying ovarian stimulation treatment can promote pregnancy rate.
作者
刘洪雪
李健
罗平
LIU Hongxue LI Jian LUO Ping(Medical College of Xiamen University, Maternal and Child Health Care Hospital of Xiamen, Xiamen Fujian 361003, China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2017年第2期144-147,共4页
Journal of Practical Obstetrics and Gynecology
关键词
子宫内膜异位症
不孕
妊娠率
影响因素
宫-腹腔镜联合治疗
Endometriosis
Infertility
Pregnancy rate
Influence factors
Laparoscopy combined with hysteroscopy treatment
