宫腔镜-腹腔镜联合治疗子宫内膜异位症伴不孕患者术后妊娠的影响因素

摘要

Objective To investigate the related factors of postoperative pregnancy in patients with endometrio-sis infertility treated by hysteroscopy and laparoscopy.Methods From January 2015 to January 2016,207 patients with endometriosis and infertility who underwent hysteroscopy and laparoscopy treatment in our hospital were studied.The pregnancy rate of postoperative 1 year were recorded,and the related factors influencing postoperative pregnancy were statistically analyzed.Results For the laparoscopy combined with hysteroscopy in the treatment of endometriosis and infertility patients,the pregnancy rate of postoperative 1 year was 36.23%(75/207);single factor analysis showed that there were significant differences between the pregnant group and non-pregnant group in age,BMI,duration of infertili-ty,abdominal surgery,r-AFS stage,pathological type and use of standardized postoperative medication,application of as-sisted reproductive technology(P<0.05);multivariate logistic regression analysis showed that age,r-AFS stage were in-dependent risk factors for pregnancy(P<0.05),and postoperative standardized medication and assisted reproductive tech-nology are protective factors(P<0.05).Conclusion The hysteroscopy and laparoscopy has good clinical curative effect in the treatment of endometriosis and infertility patients.Age and r-AFS stage can affect the postoperative pregnancy, and postoperative standardized medication and assisted reproductive technology are beneficial to improve the postopera-tive pregnancy rate.%目的 探讨宫腔镜-腹腔镜联合治疗子宫内膜异位症伴不孕患者术后妊娠的影响因素.方法 选择2015年1月至2016年1月期间深圳市松岗人民医院妇科收治的207例子宫内膜异位症伴不孕症患者,均接受宫腔镜-腹腔镜联合治疗,记录患者术后1年妊娠率,并对影响术后妊娠的相关因素进行统计学分析.结果 宫腔镜-腹腔镜联合治疗子宫内膜异位症伴不孕患者术后1年内的妊娠率为36.23%(75/207);单因素分析结果显示,妊娠组与未妊娠组在年龄、BMI、不孕时间、腹部手术史、r-AFS分期、病理分型及是否使用术后规范用药、是否应用辅助生殖技术方面比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,年龄、r-AFS分期是影响术后妊娠的独立危险因素(P<0.05),术后规范用药和辅助生殖技术是保护性因素(P<0.05).结论 宫腔镜-腹腔镜联合治疗子宫内膜异位症伴不孕患者具有较好的临床疗效,其中年龄大、r-AFS分期高可影响术后妊娠,术后规范用药及辅助生殖技术有助于提高术后妊娠率.