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目的:调查腹腔镜下行子宫肌瘤剔除术不孕症患者的妊娠情况,探讨其相关影响因素。方法:选取2013年1月~2014年1月在该院妇科接受腹腔镜下行子宫肌瘤剔除术治疗的110例子宫肌瘤患者为研究对象,对其术后妊娠情况进行调查分析。通过随访病历调查患者接受手术时的年龄、孕产史(有无不孕史及妊娠丢失)、术前妇科超声检查结果 (子宫肌瘤大小、形态、数目和生长位置等)、手术持续时间、术中出血量、术后妊娠情况等各项指标进行记录。结果:110例患者中子宫肌瘤剔除术后妊娠成功的75例为妊娠成功组,成功率为68.18%(75/110);未妊娠者35例设为未成功组。成功组患者中年龄<40岁的70例,占93.33%(70/75),高于未成功组的25例,占71.43%(25/35);成功组患者中术前不孕年限<3年的57例,占76.00%(57/75),高于未成功组的12例,占34.29%(12/35),差异有统计学意义(χ2=7.92、17.76,P<0.05);成功组患者盆腔粘连程度明显低于未成功组(χ2=12.18,P<0.05)。两组患者在肌瘤数量方面比较,成功组患者单个肌瘤55个,占73.33%(55/75),高于未成功组的15例,占42.86%(15/35),差异有统计学意义(χ2=4.21,P<0.05)。两组患者在肌瘤大小及肌瘤位置方面比较差异无统计学意义(χ2=2.39、0.34,P>0.05)。结论:年龄、不孕年限、剔除肌瘤数目、盆腔粘连程度等4个因素对子宫肌瘤患者术后妊娠的影响差异有统计学意义,均为术后妊娠的危险因素。
Objective: To investigate the pregnancy status of laparoscopic infertility patients with myomectomy and to explore the related factors. Methods: From January 2013 to January 2014, 110 cases of uterine leiomyoma treated by laparoscopic gynecological myomectomy in gynecology hospital from January 2013 to January 2014 were selected as research subjects, and the postoperative pregnancy was investigated. The follow-up medical records were used to investigate the age, pregnancy history (with or without pregnancy history and pregnancy loss), preoperative gynecological ultrasonography (size, shape, number and growth location of the uterine fibroids), duration of operation, The amount of bleeding, postoperative pregnancy and other indicators of the record. Results: Among the 110 cases, 75 cases of successful pregnancy after uterine myomectomy were successful pregnancy, with a success rate of 68.18% (75/110); 35 cases of non-pregnant women as unsuccessful group. In the successful group, 70 cases were aged <40 years, accounting for 93.33% (70/75), which was higher than that in the unsuccessful group (71.43%, 25/35). In the successful group, the preoperative infertility duration was less than 3 Year, 57 cases accounted for 76.00% (57/75), higher than the unsuccessful group of 12 cases, accounting for 34.29% (12/35), the difference was statistically significant (χ2 = 7.92,17.76, P <0.05); successful Group pelvic adhesion was significantly lower than the unsuccessful group (χ2 = 12.18, P <0.05). In the two groups of patients, the number of fibroids was 55 in the successful group, accounting for 73.33% (55/75), higher than the 15 cases (42.86%, 15/35) in the unsuccessful group, the difference was statistically significant Significance (χ2 = 4.21, P <0.05). There was no significant difference between the two groups in fibroid size and fibroid location (χ2 = 2.39,0.34, P> 0.05). Conclusion: There are significant differences in the effects of age, age of infertility, number of fibroids removed and pelvic adhesions on postoperative pregnancy in patients with uterine fibroids, all of which are risk factors for postoperative pregnancy.