不孕症患者腹腔镜子宫肌瘤剔除术后远期妊娠影响因素分析  

Analysis of the factors affecting the long-term pregnancy situation of infertile patients after laparoscopic uterine myomectomy

作　　者：黄宗玉 潘昌玲[1] 左文文 HUIANG Zongyu;PAN Changling;ZUO Wenwen(Lishui Central Hospital,Lishui,Zhejiang Province,323000)

机构地区：[1]浙江省丽水市中心医院,323000

出　　处：《中国计划生育学杂志》2023年第10期2472-2476,2481,共6页Chinese Journal of Family Planning

摘　　要：目的:探究不孕症患者接受腹腔镜或开腹手术治疗子宫肌瘤的远期妊娠情况及影响妊娠因素。方法:回顾性收集本院2019年1月-2022年1月因子宫肌瘤导致不孕的336例患者临床资料,根据手术方法不同分为腹腔镜组和开腹子组,对比两组手术指标及远期妊娠情况,探究影响腹腔镜手术患者远期妊娠相关因素。结果:腹腔镜组手术时间(105.46±28.82min)长于开腹组(94.22±24.62min),术中出血量(92.46±40.73ml)少于开腹组(133.31±33.60ml),肌瘤剔除数(1.86±1.23个)少于开腹组(2.04±1.35个)(P<0.05),两组剔除肌瘤最大直径(5.42±1.80cm、6.31±1.62cm)无差异(P>0.05)。术后随访时间腹腔镜组(30.2±9.1月)长于开腹组(29.6±11.0月),远期妊娠率腹腔镜组(58.3%)高于开腹组(47.0%)(P<0.05),两组足月妊娠、分娩方式、并发子宫破裂(0例、4例)无差异(P>0.05)。多因素logistic回归分析,腹腔镜组术前不孕时间增加,术后妊娠率降低(P=0.004)。结论:子宫肌瘤引起的不孕症患者接受腹腔镜下子宫肌瘤剔除术后妊娠率提高,且妊娠分娩期间相对安全,临床应积极治疗子宫肌瘤,降低对妊娠的影响。Objective:To explore the long-term pregnancy situation of infertile patients who had undergone laparoscopic or transabdominal uterine myomectomyfor treating uterine leiomyoma,and to study therelated factors affecting thelong-term pregnancy of the patients after laparoscopic myomectomy.Methods:The clinical data of 336 patients withinfertility caused byuterine leiomyoma from January 2019 to January 2022 were collected retrospectively.These pa-tients were divided into group A(the patients with laparoscopic uterine myomectomy)and group B(the patients withtransabdominal uterinemyomectomy)according to different surgeries.The surgical indicators and thelong-term preg-nancy situation of the patients were compared between the two groups.The related factors affecting the long-termpregnancy of the patients who had undergone laparoscopic surgery were explored.Results:The operative time(105.46±28.82min)of the patients in groupAwas significantly longer than that(94.22±24.62min)of the patients in groupB,and the intraoperative blood loss(92.46±40.73ml)of the Patients in group A was significantly less than that(133.31+33.60ml)of the patients in group B.The numberof removed uterine leiomyoma(1.86±1.23)of the patientsingroup Awas significantlyless than that(2.04±1.35)of the patients ingroup B(P<0.05).There was no significantdifference in themaximum diameter of theremoved uterine leiomyoma(5.42±1.80cm vs.6.31±1.62cm)of the pa-tients between the twogroups(P>0.05).The time of postoperativefollowed up(30.2±9.1 months)of thepatients ingroup A was significantly longer than that(29.6±11.0 months)of the patients in group B.The long-term pregnancyrate(58.3%)of thepatients in group A was significantly higherthan that(47.0%)of the patients in group B(P<O.05).There was no significant difference in the rate of full-term pregnancy,the delivery mode,and the uterine rup-ture number(0 cases vs.4 cases)of the patients between the two groups(P>0.05).Multivariate logistic regression a-nalysis showed that the longer the duration of preoperativ

关 键 词：不孕症 腹腔镜下子宫肌瘤剔除术 经腹子宫肌瘤剔除术 术后远期妊娠 影响因素 

分 类 号：R737.33[医药卫生—肿瘤] R711.6[医药卫生—临床医学]