影响腹腔镜治疗不孕症疗效的多因素分析  

Multivariance Analysis on the Efficacy of Laparoscopy for Female Infertility

作　　者：段爱红[1] 卢丹[1] 张建萍[1] 汤丽荣[1] 

机构地区：[1]首都医科大学附属北京妇产医院妇科,北京100026

出　　处：《中国微创外科杂志》2011年第1期58-60,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨影响腹腔镜手术治疗不孕症疗效的主要因素。方法回顾性分析2003年11月～2008年6月我科行腹腔镜手术并完成随访的507例不孕症患者的临床资料。对可能影响术后妊娠率的年龄、不孕年限、宫内节育器(IUD)史、妊娠史、异位妊娠史、人工流产史、手术史、盆腔炎史进行单因素分析,对P<0.05的因素进一步做Logistic回归分析。结果所有患者术后随访12～60个月,术后妊娠241例,总妊娠率47.5%,其中术后随访满2年的患者的术后妊娠率为55.2%(190/344)。根据腹腔镜探查结果,盆腔正常、盆腔炎性疾病(PID)、卵巢或盆腔子宫内膜异位症(EM)、其他因素患者的妊娠率分别为59.5%(78/131)、37.9%(92/243)、44.6%(41/92)、73.2%(30/41)。经单因素分析,年龄、不孕年限及放置IUD史、盆腔病变类型对术后妊娠结局的影响有统计学意义(P值均<0.05)。经Logistic综合评估各因素,不孕年限、放置IUD史是影响手术疗效的主要因素。结论影响腹腔镜治疗不孕症疗效的主要因素为不孕年限>3年和既往放置IUD史,有这些因素的患者腹腔镜手术的妊娠率低。Objective To investigate the major factors affecting the pregnancy rate after laparoscopic treatment for female infertility. Methods We retrospectively analyzed the clinical data of 507 infertile women who underwent laparoscopy in the Gynecology Departmen ut of Beijing Obstetrics and Gynecology Hospital and completed follow up during November 2003 to July 2008. One way ANOVA was employed to analyze the effects of age, course of infertility, and histories of IUD, pregnancy, ectopic pregnancy, artificial abortion, surgery, and pelvic inflammation on post laparoscopy pregnancy rate; and then for the P 〈 0.05 factors, logistic regression was used for further investigation. Results All the patients received a followp for 12 to 60 months, 241 （47.5%） of them achieved pregnancy during the period. Of the 507 patients, 344 cases were followed up for over two years, of whom the pregnancy rate was 55.2% （190/344）. The pregnancy rate in the patients with normal pelvis, PID, or ovarian or pelvic EM was 59.5% （78/131） , 37.9% （92/243） , and 44.6% （41/92） respectively; and in those with other diseases, the pregnancy rate was 73.2% （30/41）. One way ANOVA showed that age, course of infertility, and histories of IUD and pelvic diseases are significant factors influencing post-laparoscopy pregnancy rate （ P 〈 0.05 ）. Logistic regression then confirmed that course of infertility and history of IUD are major factors affecting the therapeutic outcomes of laparoscopy. Conclusions Course of infertility over 3 years and history of IUD are the major factors leading to low pregnancy rate after laparoscopy for female infertility

关 键 词：不孕症 腹腔镜 妊娠率 疗效 

分 类 号：R713.7[医药卫生—妇产科学]