论文部分内容阅读
目的对腹腔镜术后子宫内膜异位症(endometriosis,EMT)合并不孕的患者进行不同分组及指导妊娠,探索提高术后妊娠率的方法。方法应用ASRM分期对2010年1月至2011年6月在北京妇产医院妇科行腹腔镜手术的146例EMT合并不孕的患者进行前瞻性研究,对ASRM分期的各期患者制定不同的妊娠指导方案,术后随访5年,统计妊娠率、妊娠结局及复发率。结果 (1)总妊娠率为89.04%,各期均获得满意妊娠率。ASRM分期与术后自然妊娠率(χ~2=4.069,P=0.254)、足月分娩(χ~2=0.605,P=0.895)及自然流产(χ~2=0.394,P=0.942)的比率没有显著性差异。(2)术后5年复发率为9.6%(14/146),78.6%的患者在术后2年内复发。结论 EMT分期与术后妊娠率无明确相关性。对EMT合并不孕的患者术后进行严格管理并制定积极的妊娠方案能显著提高此类患者的妊娠率。
Objective To differentiate and guide pregnancy after laparoscopic endometriosis (EMT) with infertility and to explore ways to improve postoperative pregnancy rate. Methods A total of 146 patients with EMT with infertility undergoing laparoscopic gynecology in Beijing Maternity Hospital from January 2010 to June 2011 were prospectively studied by using ASRM staging. Different pregnancy guidelines were developed for all stages of ASRM staging Program, 5-year follow-up, statistical pregnancy rate, pregnancy outcome and recurrence rate. Results (1) The total pregnancy rate was 89.04%, with satisfactory pregnancy rates in all stages. The ratio of ASRM staging and postoperative spontaneous pregnancy rate (χ ~ 2 = 4.069, P = 0.254), full term delivery (χ ~ 2 = 0.605, P = 0.895) and spontaneous abortion (χ ~ 2 = 0.394, P = 0.942) No significant difference. (2) The recurrence rate after 5 years was 9.6% (14/146), and 78.6% patients relapsed within 2 years after operation. Conclusion There is no clear correlation between EMT staging and postoperative pregnancy rate. Strict management of patients with EMT with infertility and the development of a positive pregnancy regimen can significantly improve the pregnancy rate of such patients.