子宫内膜异位症合并不孕症患者术后自然妊娠率的影响因素分析
本文选题:子宫内膜异位症 + 不孕症 ; 参考:《中国现代医学杂志》2017年12期
【摘要】:目的观察子宫内膜异位症(EMT)合并不孕症患者接受开腹或腹腔镜手术治疗后的妊娠情况,并分析各种因素对术后自然妊娠率的影响。方法选取2011年1月-2014年1月因不孕并且有生育要求而就诊于苏州大学附属第一医院的女性患者的临床资料,以确诊为EMT的138例患者为研究对象。统计分析患者一般临床资料及手术情况,分析术后自然妊娠率及相关影响因素。结果完成随访的138例患者中,45例患者自然妊娠,总体受孕率为32.61%,多因素Logistic回归分析提示影响EMT患者术后自然妊娠率的相关因素为:年龄、不孕类型、临床病理类型、修正子宫内膜异位症分期法(r-AFS)、术前抗穆勒氏管激素(AMH)和是否术后促性腺激素释放激素类似物(Gn RH-a)治疗,各因素间比较,差异有统计学意义(P0.05)。结论手术可提高EMT不孕症患者的术后自然妊娠率,是治疗EMT不孕症的有效手段,并且术后6~12个月自然妊娠率最大,是妊娠的最佳时机,此后随着时间的延长,妊娠率不断下降。患者年龄、不孕类别、临床病理类型、r-AFS分期、术前AMH水平及术后是否使用Gn RH-a是影响EMT不孕症患者术后自然妊娠率的重要因素。
[Abstract]:Objective to observe the pregnancy of patients with endometriosis combined with infertility after laparoscopy or laparoscopy, and to analyze the influence of various factors on the rate of spontaneous pregnancy after operation. Methods from January 2011 to January 2014, the clinical data of female patients who were hospitalized in the first affiliated Hospital of Suzhou University because of infertility and fertility requirement were selected. 138 patients diagnosed as EMT were selected as the study objects. The general clinical data and surgical conditions were analyzed, and the natural pregnancy rate and related influencing factors were analyzed. Results 45 cases of spontaneous pregnancy were followed up. The overall pregnancy rate was 32.61%. The multivariate Logistic regression analysis showed that the related factors affecting the spontaneous pregnancy rate of EMT patients were age, type of infertility, clinicopathologic type. There was a significant difference between the two groups in the treatment of endometriosis by modifying the staging of endometriosis by r-AFS, anti-Muller tube hormone (AMH) before operation and whether gonadotropin releasing hormone analogues (Gn RH-a) were treated after operation. There was significant difference between the two groups (P 0.05). Conclusion Operation can improve the rate of spontaneous pregnancy in patients with EMT infertility, and it is an effective method for the treatment of EMT infertility. The natural pregnancy rate is the largest in 6 ~ 12 months after operation, and it is the best time for pregnancy. After that, the pregnancy rate decreases continuously with the prolongation of time. Age, type of infertility, clinicopathologic type and r-AFS staging, preoperative AMH level and postoperative use of Gn RH-a were important factors influencing the spontaneous pregnancy rate in patients with EMT infertility.
【作者单位】: 苏州大学附属第一医院妇产科;
【分类号】:R713.7
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