|本期目录/Table of Contents|

[1]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(05):326-329.
 WU Nengxiu,XIE Xi,LIU Chaobin,et al.Analysis on Influencing Factors of Pregnancy in Patients Who Underwent Laparoscopic Surgery for Endometriosis with Infertility[J].Journal of Fujian Medical University,2017,51(05):326-329.
点击复制

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(PDF)
分享到:

《福建医科大学学报》[ISSN:1672-4194/CN:35-1192/R]

卷:
第51卷
期数:
2017年05期
页码:
326-329
栏目:
临床研究
出版日期:
2017-10-30

文章信息/Info

Title:
Analysis on Influencing Factors of Pregnancy in Patients Who Underwent Laparoscopic Surgery for Endometriosis with Infertility
文章编号:
16724194(2017)05032604
作者:
吴能秀 谢熙 刘超斌 易劲松 苏彦钊 王真红
作者单位: 福建医科大学 附属福建省妇幼保健院妇产科,福州350001
Author(s):
WU Nengxiu XIE Xi LIU Chaobin YI Jingsong SU Yanzhao WANG Zhenhong
Department of Gynecology and Obstetrics, Fujian Provincial Maternity and Children’s Hospital of Fujian Medical University, Fuzhou 350001, China
关键词:
子宫内膜异位症 不孕女(雌)性 腹腔镜 妊娠率 妊娠结局
Keywords:
KEY WORDS:endometriosis infertility female laparoscopic pregnancy rates pregnancy outcome
分类号:
R443.8; R711.6; R711.71
DOI:
-
文献标志码:
A
摘要:
目的探讨腹腔镜手术治疗盆腔内子宫内膜异位症伴不孕症患者的术后妊娠率、妊娠结局及相关影响因素。方法收集2010年1月-2014年12月行腹腔镜手术且术后病理确诊为盆腔内子宫内膜异位症合并不孕症的患者250例,回顾性分析其临床资料,随访其术后获得妊娠的时间、妊娠方式及妊娠结局等,并分析相关影响因素,随访时间为术后1~5年。结果250例中,7例(2.8%)失访,随访的243例中,妊娠185例,其中自然妊娠148例(60.9%),体外受精胚胎移植(IVFET)术妊娠37例。自然妊娠的148例中,于术后12月内妊娠者124例(83.8%)。不同年龄的患者术后妊娠率及妊娠结局比较差别有统计学意义,<30岁者优于≥30岁者(P<0.05);术后妊娠率与卵巢子宫内膜异位囊肿侧别有关,右侧患者术后妊娠率高于左侧及双侧患者,差别有统计学意义(P<0.05);而不同rAFS分期、不孕类型患者的术后妊娠率及妊娠结局比较差别则无统计学意义(P>0.05)。结论腹腔镜手术能有效提高盆腔子宫内膜异位症伴不孕症患者的术后妊娠率;术后1年是最佳的妊娠时间,年龄越大,术后妊娠率越低、妊娠结局越差。发生卵巢内膜异位囊肿的侧别可能与术后妊娠率有关;rAFS分期、不孕类型对术后妊娠率及妊娠结局可能无明显影响。
Abstract:
ABSTRACT:ObjectiveTo investigate the postoperative pregnancy rate, pregnancy outcome and related influencing factors of endometriosis with infertility treated by laparoscopic surgery.MethodsWe retrospectively analyzed patients undergoing laparoscopic surgery in the period of October 2010 to December 2014, and we included patients whose postoperative pathology confirmed endometriosis and infertility.Their postoperative pregnancy time, pregnancy outcome, and influenced factors in one to five years were analyzed.ResultsThere were 250 patients who met the criteria, 7 of whom failed to be followed up (2.8%).Of the 243 patients, 185 were pregnant including 148 natural pregnant cases and 37 IVFET cases.Natural pregnancy rate was 60.9%, in which 124 cases (83.8%) got pregnant 12 months postoperatively.Patients of different age showed significant different postoperative rate and outcome.Patients under 30 years old had better pregnancy rate and outcome than patients aged over 30 (P<0.05).Postoperative pregnancy rate correlated with the side of ovarian cyst.Right side ovarian endometriotic cyst had statistically higher rate of pregnancy than that of left side or bilateral ovarian endometriotic cyst(P<0.05).There was no significant difference in postoperative pregnancy rate and pregnancy outcome between different rAFS staging and infertility type (P>0.05).ConclusionsLaparoscopic surgery can effectively improve the postoperative pregnancy rate for patients with endometriosis and infertility.The best pregnancy time is one year postoperatively.The older the patients, the lower the postoperative pregnancy rate and the poorer outcome.Postoperative pregnancy rate is associated with the side of ovarian cyst.rAFS staging and infertility type has no significant effect on postoperative pregnancy rate and outcomes.

参考文献/References:

[1]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.
[2]American Society for Reproductive Medicine. Revised American Society for Reporductive Medicine classification of endometriosis:1996[J]. Fertil Steril, 1997,67(5):817821.
[3]李焱, 张震宇, 刘崇东, 等. 子宫内膜异位症合并不孕患者腹腔镜术后药物治疗妊娠结局分析[J]. 实用妇产科杂志, 2015,31(1):5356.
[4]Malinowski A, Nowak M, MaciolekBlewniewska G, et al. The place of laparoscopy in gynecological practiceuseful technique for diagnostic and treatment of infertility and endometriosis[J]. Ginekol Pol, 2001,72(12A):13471354.
[5]葛春晓, 朱湘虹, 汤晓秋, 等. 腹腔镜保守性手术联合戈舍瑞林治疗重度卵巢内异症206例近远期疗效分析[J]. 中华妇产科杂志, 2012,47(8):603607.
[6]黄思毅, 李末娟. 腹腔镜手术治疗子宫内膜异位症伴不孕178例[J]. 实用医学杂志, 2012,28(10):16731675.
[7]刘丹, 张治宁, 哈春芳, 等. 子宫内膜异位症相关性不孕患者腹腔镜术后生殖预后的影响因素分析[J]. 实用妇产科杂志, 2013,29(1):5255.
[8]戴燕, 刘超斌, 林元, 等. 不同年龄子宫内膜异位症手术患者179例临床分析[J]. 福建医科大学学报, 2013,47(3):172175.
[9]杨冬梓. 内异症合并不孕处理中的几个问题[J]. 中华妇产科杂志, 2013,48(1):35.
[10]李翠玲, 李晓吉, 马玉兰, 等.腹腔镜手术治疗子宫内膜异位症伴不孕104例[J]. 中国微创外科杂志, 2009,9(9):790792.
[11]冷金花, 郎景和, 赵学英, 等. 盆腔子宫内膜异位症病灶分布特点及其腹腔镜诊断准确性的评价[J]. 中华妇产科杂志, 2006,41(2):111113.
[12]Cirpan T, Akman L, Yucebilgin M S, et al. Reproductive outcome after surgical treatment of endometriosis retrospective analytical study[J]. Ginekol Pol, 2013,84(12):10411044.

相似文献/References:

备注/Memo

备注/Memo:
基金项目: 福建省临床重点专科建设项目(闽卫科教[2012]149) 作者单位: 福建医科大学 附属福建省妇幼保健院妇产科,福州350001 作者简介: 吴能秀,女,主治医师 通讯作者: 谢熙. Email: xiexi668@sina.com
更新日期/Last Update: 2017-10-30