不孕症患者子宫腺肌病病灶切除术后的妊娠情况研究  

Study on pregnancy outcome of infertility patients after resection of adenomyosis

作　　者：刘婷婷[1] 郑明康[1] 袁艳艳[1] 

机构地区：[1]广东省珠海市妇幼保健院妇一科,广东珠海519000

出　　处：《中国医药导报》2017年第8期92-95,共4页China Medical Herald

基　　金：广东省珠海市科技计划项目(02655911140623031)

摘　　要：目的研究不孕症患者子宫腺肌病病灶切除术后的妊娠情况,探讨手术对患者受孕率和妊娠情况改善是否有帮助。方法选择广东省珠海市妇幼保健院2014年7月~2015年6月因不孕症行子宫腺肌病病灶切除术患者114例,根据子宫腺肌病或子宫腺肌瘤分布部位和病灶大小分为A、B、C组,A组(46例):病灶主要在前壁;B组(58例):病灶主要在后壁;C组(10例):病灶弥漫全子宫。分析术后患者痛经变化情况及妊娠情况。结果术后6个月随访,患者痛经改善明显,A组痛经缓解率86.5%,B组痛经缓解率85.4%,C组痛经缓解率80.0%,差异无统计学意义(χ~2=0.152,P>0.05)。术后随访0.5~2年,68例患者受孕,总的受孕率59.6%,第1年受孕率24.5%,第2年受孕率35.1%;病灶大小不同受孕率比较,差异有统计学意义(χ~2=11.802,P<0.05)。受孕后足月产率75.0%,流产率14.7%,早产率10.3%,先兆子宫破裂率4.4%。结论不孕症患者子宫腺肌病病灶切除术后能有效缓解患者的痛经情况,并能明显提高患者受孕率,病灶范围越小术后受孕率越高。Objective To investigate pregnancy outcome of infertility patients after resection of adenomyosis, and to study whether lesionectomy is effective in improving pregnancy rate. Methods 114 patients with adenomyosis infertility undergoing lesionectomy in Maternal and Child Health Care Hospital, Guangdong Province from July 2014 to June2015 were selected and divided into group A, B, C according to the location of uterine adenomyosis or uterine fibroids and lesion size. Group A（n = 46）： the lesions were mainly in the anterior wall; group B（n = 58）： the lesions were mainly in the posterior wall; group C（n = 10）： the lesions were diffuse throughout the uterus. Changes of dysmenorrhea and pregnancy in patients after operation were analyzed. Results Follow up 6 months after operation, dysmenorrhea of patient was improved significantly, dysmenorrhea remission rate in group A was 86.5%, dysmenorrhea remission rate in group B was 85.4%, dysmenorrhea remission rate in group C was 80.0%, with no statistical differences（χ~2=0.152, P 〉 0.05）. All patients were followed up for 0.5 to 2 years, 68 patients were conceived, total pregnancy rate was 59.6%. First year pregnancy rate was 24.5%, the second year pregnancy rate was 35.1%. Pregnancy rate with different lesion size was compared, with statistical difference（χ~2=11.802, P 〈 0.05）. The term yield was 75.0%, abortion rate was 14.7%,premature delivery rate was 10.3%, threatened uterine rupture rate was 4.4%. Conclusion Infertility patients with adenomyosis after resection of the lesion can effectively relieve dysmenorrheal, significantly improve the pregnancy rate. The smaller the range of lesions, the higher the pregnancy rate.

关 键 词：不孕症 子宫腺肌病 痛经 妊娠 

分 类 号：R711.74[医药卫生—妇产科学]