子宫肌瘤剔除影响术后妊娠的相关因素分析

摘要

Objective To discuss the influencing factors for pregnancy after myomectomy. Methods 152 female pa-tients (under 40 years old) who received myomectomy at the Minimally Invasive Surgery Center of Beijing Obstetrics and Gyne-cology Hospital from Jun 2005 to May 2010, having never given birth but with reproductive requirements, were selected as the subjects of this study. Retrospective analysis was carried out for the clinical information and telephone follow-up was performed to gather patients' information about pregnancy situation after surgery. Results Via multivariate Logistic regression analysis, infertility history (P=0.011,P<0.05) and age (P=0.000,P<0.05) were the influencing factors for post-operative pregnancy rate. The probability of pregnancy for patients without infertility history was about 3 times of that for patients with infertility history (OR=3.021,95%CI 1.288~7.082). The pregnancy possibility of patients aged below 35 was about 9 times of that for patients aged above 35 (OR=9.264,95%CI 3.783~22.683). But the fibroids type (P=0.207), size (P=0.594),quantity (P=0.813) and surgical method(P=0.150) all had no statistically significant influence on post-operative pregnancy rate. Conclusion Af-ter myomectomy, main influencing factors on pregnancy are pre-operative infertility history and patient's age.Therefore, the in-fertility patients with uterine fibroids should undergo myomectomy as soon as possible to increase the rate of pregnancy.%目的：分析子宫肌瘤剔除影响术后妊娠的相关因素。方法选择2005年6月～2010年5月在北京妇产医院微创中心行子宫肌瘤剔除术，尚未生育但有生育愿望，且不合并其他影响妊娠因素的152例患者的临床资料及随访结果，回顾性分析影响术后妊娠的相关因素。结果 Logistic 多元回归分析表明术前不孕史（P=0.011）及年龄（P=0.000）是影响术后妊娠的因素，其中术前无不孕史子宫肌瘤患者术后妊娠的可能性是肌瘤性不孕患者的3倍左右（OR=3.021，95％CI 1.288～7.082），<35岁患者术后妊娠的可能性是≥35岁患者的9倍左右（OR=9.264，95％CI 3.783～22.683）。而肌瘤类型（P=0.207）、大小（P=0.594）、数目（P=0.813）、手术方式（P=0.150）对术后妊娠的影响均无统计学意义。结论子宫肌瘤剔除影响妊娠的因素是术前不孕史和年龄。因此，合并不孕的子宫肌瘤患者应尽早剔除肌瘤，提高妊娠率。