卵巢子宫内膜异位囊肿不孕患者腹腔镜术后妊娠结局的影响因素分析  

Analysis of influence factors of pregnancy outcome in patients with ovarian endometriomas after laparoscopic surgery

作　　者：王凯丽[1] 祁秀娟[1] WANG Kai-li;QI Xiu-juan(Reproductive Medical Centre of Qingdao University Aff iliated Hospital,Qingdao 266100)

机构地区：[1]青岛大学附属医院生殖医学科,青岛266100

出　　处：《生殖医学杂志》2019年第5期488-493,共6页Journal of Reproductive Medicine

摘　　要：目的分析134例不孕症并卵巢子宫内膜异位囊肿而行腹腔镜囊肿剥除术患者术后的妊娠结局及其影响因素,以期为患者选择合理的治疗方案提供参考。方法回顾性分析134例不孕症并卵巢内异囊肿患者的病历资料,随访时间1～3年。结果术后患者全部自然试孕,成功妊娠43例,自然妊娠率32.09%,其中31例(72.1%)于术后6个月内成功妊娠;自然试孕失败后选择IVF-ET助孕49例,成功妊娠33例。与自然妊娠失败组相比,自然妊娠成功组患者年龄较小、不孕年限较短、生育指数(EFI)较高(P<0.05),其中高龄[OR1.809,95%CI(0.702,0.932]是独立危险因素(P<0.05)。与助孕失败组相比,助孕成功组的EFI更高(P<0.05),高龄[OR1.726,95%CI(0.563,0.935]和囊肿多发[OR1.049,95%CI(0.004,0.555]是影响妊娠结局的危险因素(P<0.05)。结论年龄、不孕年限、囊肿单/多发性、EFI与卵巢内异囊肿患者妊娠结局相关,建议内异囊肿患者术前、术中充分评估卵巢功能,术后自然试孕不超过6个月,尽早行IVF-ET助孕可显著提高妊娠率。Objective:To analyze the pregnancy outcomes and its influence factors in 134 infertile patients with ovarian endometriomas,In order to provide a reference for patients to choose a reasonable treatment protocol.Methods:The clinical data of 134 infertile patients with ovarian endometriomas were analyzed,and the follow-up time was 1 to 3 years.Results:All patients tried to natural pregnancy after the surgery.Forty three patients got successful pregnancy,and the natural pregnancy rate was 32.09%;of which 31 patients(72.1%)were successfully pregnant within 6 months after surgery.Forty nine patients selected the treatment of IVF-ET after natural pregnancy failure;33 got pregnancy.Compared with the natural pregnant failure group,the patients with natural pregnant were younger;and their infertility period was shorter and endometriosis infertility index(EFI)was higher(P<0.05).Among them,the age[OR1.809,95%CI(0.702,0.932)]was an independent risk factor(P<0.05).Compared with the IVF-ET pregnant failure group,the patients with successful pregnant after IVF-ET had higher EFI(P<0.05),older age [OR 1.726,95%CI(0.563,0.935)]and multiple cysts[OR1.049,95%CI(0.004,0.555)]were risk factors for pregnancy outcome(P<0.05).Conclusions:Age,duration of infertility,endometriomas single/multiple and EFI are closely related to the pregnancy outcome of infertile patients with ovarian endometriomas.It is recommended that the patients with endometriomas should be fully evaluated ovarian function before and during surgery.Natural pregnancy test should be not more than 6 months after surgery.Early IVF-ET can significantly improve pregnancy rate.

关 键 词：卵巢子宫内膜异位囊肿 腹腔镜卵巢囊肿剥除术 妊娠结局 因素分析 

分 类 号：R713.6[医药卫生—妇产科学] R711.6[医药卫生—临床医学]