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影响
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摘要
目的分析腹腔镜手术对子宫内膜异位症(EMT)合并不孕症患者治疗后的妊娠结局及相关影响因素。方法 2013年1月至2015年12月选择在海南妇产科医院进行腹腔镜手术治疗EMT合并不孕症患者126例,分析术后24个月的妊娠情况、妊娠结局及相关因素的影响。结果术后24个月,累积妊娠率51.59%,良好妊娠结局率为34.13%,不同年龄、术后时间、不孕年限、不孕类型患者的妊娠率及良好妊娠结局率不同(P <0.05),而临床病理分型,r-AFS分期Ⅰ、Ⅱ期之间,Ⅲ、Ⅳ之间与术后妊娠率及良好妊娠结局率差异无统计学意义(P>0.05)。结论年龄、术后时间、不孕年限、不孕类型与EMT合并不孕症患者是否妊娠及妊娠结局有关,而目前的证据无法提示临床病理分型,r-AFS分期Ⅰ、Ⅱ期之间,Ⅲ、Ⅳ之间与术后妊娠率及良好妊娠结局率有关。
Objective To analyze the pregnancy outcome and related factors after laparoscopic surgery of patients with endometriosis(EMT) combined with infertility. Methods From January 2013 to December 2015, 126 cases of EMT combined with infertility were treated by laparoscopy in Hainan obstetrics and gynecology hospital. The effects of pregnancy, pregnancy outcome and related factors were analyzed for 24 months after the operation. Results The cumulative pregnancy rate was 51.59%, the rate of good pregnancy outcomes was 34.13% 24 months after operation. There was significant difference in pregnancy rate and good pregnancy outcomes among different age, postoperative time, infertility years and types of infertility(P < 0.05), but there was no signiícant difference in clinicopathological classiícation, r-AFS stages betweenⅠand Ⅱ, Ⅲ and Ⅳ and postoperative pregnancy rate and good pregnancy outcomes(P > 0.05). Conclusions Age, duration of post operation, duration of infertility and type of infertility are related to pregnancy outcomes in patients with EMT and infertility. Current evidence could not suggest clinicopathological classiícation, the r-AFS stages between Ⅰ and Ⅱ, Ⅲ and Ⅳ are related to pregnancy rate and good pregnancy outcomes.
Objective To analyze the pregnancy outcome and related factors after laparoscopic surgery of patients with endometriosis(EMT) combined with infertility. Methods From January 2013 to December 2015, 126 cases of EMT combined with infertility were treated by laparoscopy in Hainan obstetrics and gynecology hospital. The effects of pregnancy, pregnancy outcome and related factors were analyzed for 24 months after the operation. Results The cumulative pregnancy rate was 51.59%, the rate of good pregnancy outcomes was 34.13% 24 months after operation. There was significant difference in pregnancy rate and good pregnancy outcomes among different age, postoperative time, infertility years and types of infertility(P < 0.05), but there was no signiícant difference in clinicopathological classiícation, r-AFS stages betweenⅠand Ⅱ, Ⅲ and Ⅳ and postoperative pregnancy rate and good pregnancy outcomes(P > 0.05). Conclusions Age, duration of post operation, duration of infertility and type of infertility are related to pregnancy outcomes in patients with EMT and infertility. Current evidence could not suggest clinicopathological classiícation, the r-AFS stages between Ⅰ and Ⅱ, Ⅲ and Ⅳ are related to pregnancy rate and good pregnancy outcomes.
引文
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[8]王玲玲,宋影.腹腔镜下治疗不孕症合并子宫内膜异位症的妊娠结局及相关因素分析[J].中国妇幼保健,2017,32(15):3588-3591.
[9]侯文杰,徐建英,王芳,等.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[J].中国现代医学杂志,2017,27(12):112-115.
[10]吴能秀,谢熙,刘超斌,等.腹腔镜手术治疗盆腔内子宫内膜异位症合并不孕症术后自然妊娠相关分析[J].福建医科大学学报,2017,51(5):326-329.
[11]张新丽,李玉洁.子宫内膜异位症r-AFS分期对不孕症的影响[J].中国继续医学教育,2016,8(23):69-70.
[2]Wang M,Hao C,Huang X,et al.Aberrant Expression of lncRNA(HOXA11-AS1)and Homeobox A(HOXA9,HOXA10,HOXA11,and HOXA13)Genes in Infertile Women With Endometriosis[J].Reprod Sci,2018,25(5):654-661.
[3]陈帆,杨华娣.腹腔镜手术联合促性腺激素释放激素激动剂对子宫内膜异位症不孕的临床疗效研究[J].中国内镜杂志,2016,22(9):71-74.
[4]中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症的诊治指南[J].中华妇产科杂志,2015,50(3):161-169.
[5]Harris HR,Wieser F,Vitonis AF,et al.Early life abuse and risk of endometriosis[J].Hum Reprod,2018,33(9):1657-1668.
[6]艾丹,钟丽珍.腹腔镜下治疗不孕症合并子宫内膜异位症的妊娠结局及相关因素分析[J].微创医学,2017(6):789-791.
[7]陈宇,郑晓莉,伍绍文,等.不同年龄段高龄孕产妇临床特点与妊娠结局的分析[J].中华妇产科杂志,2017,52(8):508-513.
[8]王玲玲,宋影.腹腔镜下治疗不孕症合并子宫内膜异位症的妊娠结局及相关因素分析[J].中国妇幼保健,2017,32(15):3588-3591.
[9]侯文杰,徐建英,王芳,等.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[J].中国现代医学杂志,2017,27(12):112-115.
[10]吴能秀,谢熙,刘超斌,等.腹腔镜手术治疗盆腔内子宫内膜异位症合并不孕症术后自然妊娠相关分析[J].福建医科大学学报,2017,51(5):326-329.
[11]张新丽,李玉洁.子宫内膜异位症r-AFS分期对不孕症的影响[J].中国继续医学教育,2016,8(23):69-70.