子宫内膜异位症合并不孕的患者经过腹腔镜手术后自然妊娠与妊娠结局的影响因素

摘要

Objective:To investigate the influencing factors of natural pregnancy and pregnancy outcome after laparoscopic surgery in patients with endometriosis and infertility.Method:The data of 50 patients with endometriosis and infertility in the pelvic cavity were retrospectively analyzed from January 2015 to December 2016. Patients were divided into pregnancy group and non pregnancy group according to whether they were pregnant within 1 year after completion of surgery.According to whether the pregnancy patients had good pregnancy outcomes, they were divided into good outcome group and adverse outcome group.Factors affecting pregnancy and pregnancy outcomes in patients with endometriosis and infertility after laparoscopy were screened by single factor analysis and multi factor analysis.Result:A total of 50 patients were included in the study,with an average age of (32.51±8.92) years old and an average number of infertility years (4.50±2.12)years.In the 1 year after the operation,32 patients were pregnant,and the rate of 1 year was 64%.There were 21 patients who had good pregnancy outcomes, and 11 cases had adverse pregnancy outcomes.The ovary has endometriosis cyst,the position of endometriosis cyst in the left ovary,were independent risk factors for pregnancy(P<0.05).Age was an independent risk factor for patients to have good pregnancy outcomes(P<0.05).Conclusion:For patients with endometriosis and infertility, pregnancy is the best choice within 1 year after completion of laparoscopic surgery,age can affect the outcome of pregnancy and pregnancy, and the location of endometriotic cyst is also related to the pregnancy rate after operation.%目的:探讨子宫内膜异位症合并不孕的患者经过腹腔镜手术后自然妊娠与妊娠结局的影响因素.方法:选择2015年1月-2016年12月在本院使用腹腔镜完成盆腔内子宫内膜异位症合并不孕症的50例患者的资料进行回顾性分析,按照患者在完成手术后1年内是否妊娠分为妊娠组与未妊娠组,按照妊娠患者是否为良好妊娠结局分为良好结局组与不良结局组,通过单因素分析与多因素分析,筛选经过腹腔镜手术治疗后的子宫内膜异位症合并不孕患者妊娠与妊娠结局的影响因素.结果:本研究共纳入50例患者,平均年龄(32.51±8.92)岁,平均不孕年限(4.50±2.12)年.在完成手术后的1年内,共有32例患者妊娠,1年受孕率为64%;出现良好妊娠结局的患者21例,出现不良妊娠结局的患者11例.年龄偏大,卵巢有子宫内膜异位囊肿,卵巢出现子宫内膜异位囊肿的位置在左侧卵巢,是患者是否妊娠的独立危险因素(P<0.05),年龄偏大是患者是否出现良好妊娠结局的独立危险因素(P<0.05).结论:对于子宫内膜异位症合并不孕症的患者,完成腹腔镜手术后1年内进行妊娠是最佳选择,年龄可以对患者是否妊娠和妊娠的结局构成影响,而发生卵巢内膜异位囊肿的位置也和手术后的妊娠率相关.