不孕症合并子宫肌瘤患者术后妊娠影响因素分析

目的探讨不孕症妇女采用腹腔镜子宫肌瘤剔除术治疗后的妊娠影响因素。方法选取168例合并肌壁间或浆膜下子宫肌瘤的不孕症患者,所有患者均采用腹腔镜下行子宫肌瘤剔除术治疗,分析患者的年龄、术前不孕年限、宫腔形态以及肿瘤位置、数量和大小等因素与术后妊娠的相关性。结果 128(76.2%)例患者在术后3.5年内妊娠。22²9岁患者的术后妊娠率明显高于3029岁患者的术后妊娠率明显高于30³8岁患者(P<0.05)。肌瘤≤5 cm且数量<3个的患者术后妊娠率高于肌瘤>5 cm且数量>5个的患者(P<0.05)。术前子宫腔未变形患者的术后妊娠率高于术前子宫腔变形的患者(P<0.05)。子宫肌瘤位置紧邻子宫内膜的患者的妊娠率高于子宫肌瘤位置远离子宫内膜的患者(P<0.05)。结论子宫肌瘤剔除术后的妊娠率与患者的年龄、宫腔形态以及子宫肌瘤位置、数量和大小相关,术中矫正宫腔形态和子宫肌瘤的生长位置,可提高术后妊娠率。

Influence factors analysis on infertile women after laparoscopic myomectomy

Objective To investigate and analyze the influence factors of pregnancy incidence on infertile women treated with laparoscopic myomectomy. Methods 168 cases in our hospital treated by lapa- roscopic downward hysteromyoma resection were collected, who had muscular wall or subserosal hysteromyoma. The probable factors such as uterine cavity form, age, time of preoperative infertility, and the location, quantity, size of tumor are retrospectively analyzed. Results 128 （76. 2% ） patients were pregnant in 3.5 years after surgery. Patients under the age of 22 - 29 had a higher pregnancy rate than patients under the age of 30 - 38 （ P 〈 0. 05 ） , and the patients with a fibroid size below 5 cm and less than 3 fibroids also had a higher pregnancy rate than patients with a fibroid size over 5 cm and more than 5 fibroids （ P 〈 0. 05 ）. The preoperative uterine cavity deformation and location adjacent to the endometrium growth were both relevant to the postoperative pregnancy rate （ P 〈 0. 05 ）. Conclusion The postoperative pregnancy rate is af- fected by the patient＇s age, uterine cavity form and the intrauterine growth location, quantity, size of uterine fibroids. The correction of uterine cavity shape and position of uterine during the operation can improve postoperative pregnancy rate.