合并子宫肌瘤的不孕女性行肌瘤剔除术后妊娠相关情况分析

摘要

Objective To study the effect of myomectomy on infertility and to evaluate the other relevant factors that influence pregnancy rate after operations. Methods By means of retrospective studies of the cases from January,2005 to Decem-ber,2010 and perspective analysis of the cases from January,2011 to June,2012 who underwent myomectomy in Beijing Ob-stetrics and Gynecology hospital,we recorded and analyzed the demographic,leiomyoma characteristics,and follow - up infor-mation of the 122 cases(131 cases in all)who were followed up after operations. Results The total pregnancy rate was 50. 8%(62 / 122),and live - birth rate was 59. 7% (40 / 67). One patient was discovered uterine scar defective healing. The pregnancy rate showed negative correlation with age〔RR = 1. 16,95% CI(1. 08,1. 24),P ﹤ 0. 001〕. The history of gravidity and pari-ty,infertility type, infertility period, leiomyomas size, number, type had no significantly influence over pregnancy rate. Conclusion Myomectomy can increase the pregnancy rate and live - birth rate for infertility women and patients′ ages show negative correlation with postoperative pregnancy rate,so it′s advisable that infertility women with leiomyomas undergo myomec-toomy.%目的：探讨子宫肌瘤剔除术对不孕女性妊娠的影响及评估影响术后妊娠的因素。方法回顾性研究2005年1月-2010年12月与前瞻性分析2011年1月-2012年6月在首都医科大学附属北京妇产医院行子宫肌瘤剔除术的131例不孕患者的临床资料，共122例在随访中，记录分析患者基本信息、肌瘤特征、术后随访数据（妊娠率、活产率等）。结果术后总妊娠率为50.8％（62/122），活产率为59.7％（40/67）；随访病例中1例发生子宫瘢痕愈合不良；年龄是影响术后妊娠的危险因素〔RR ＝1.16，95％ CI（1.08，1.24），P ﹤0.001〕，而孕产史、不孕类型、不孕时间、肌瘤大小、数目、类型均不是影响术后妊娠率的危险因素。结论合并肌瘤的不孕女性行肌瘤剔除术可增加妊娠率与活产率，术后妊娠率与患者年龄呈负相关，故合并子宫肌瘤的不孕女性应积极行肌瘤剔除术。