腹腔镜手术对子宫内膜异位症合并不孕症患者的妊娠结局及影响因素分析

Pregnancy outcomes and risk factors of laparoscopic surgery for patients with endometriosis with infertility

摘要:

目的 分析腹腔镜手术治疗对子宫内膜异位症（EMT）合并不孕症妊娠情况的影响，并探讨影响妊娠结局的因素。方法 选取青海省妇女儿童医院子宫内膜异位症合并不孕症患者120例作为研究对象，随机分为观察组与对照组，每组60例。观察组实施腹腔镜手术治疗；对照组实施常规开腹手术治疗。分析两组手术情况及2年内的妊娠结局，单因素及Logistic多因素分析妊娠率影响因素。结果 与对照组比较，观察组术中出血量、手术时间和术后住院时间均减少（P?<0.05）。随访2年，两组妊娠率、妊娠结局及子宫内膜异位症复发率比较，差异无统计学意义（P?>0.05）。单因素及多因素Logistic分析术后体外受精-胚胎移植（IVF-ET）是妊娠不良结局的主要影响因素（P?<0.05）。结论 腹腔镜治疗子宫内膜异位症合并不孕症对患者机体损伤较小，治疗后影响患者妊娠的主要因素为接受IVF-ET治疗，追溯影响妊娠结局的原因较多而不确定，因此需要大规模、深入的样本研究，进一步分析子宫内膜异位症合并不孕症患者治疗后妊娠的影响因素，从而完善治疗策略。

Abstract:

Objective To analyze the effect of laparoscopic surgery on the pregnancy of endometriosis (EMT) with infertility and risk factors of prognosis. Methods A total of 120 patients with endometriosis and infertility who were admitted to our hospital from January 2015 to June 2016 were randomly divided into the observation group (n?=?60) and control group (n?=?60). Patients in observation group underwent laparoscopic surgery, while patients in control group underwent routine laparotomy. The pregnancy outcome within 2 years and the risk factors affecting pregnancy were analyzed and compared. Results Compared with the control group, the intraoperative blood loss, operation time and postoperative hospital stay in observation group were significantly reduced (P??0.05). Univariate and logistic multivariate analysis showed that post-in vitro fertilization and embryo transfer (IVF-ET) was the main risk factor of adverse pregnancy outcome (P?