子宫内膜癌患者高效孕激素治疗后妊娠影响因素分析

Analysis of influencing factors of pregnancy in patients with endometrial carcinoma after efficiently progestational hormone therapy

目的探讨子宫内膜癌患者经高效孕激素治疗后妊娠的影响因素,为临床上提高患者妊娠率提供参考依据。方法选择2018-09-01-2020-05-01河南科技大学第一附属医院收治的子宫内膜癌患者为研究对象,将其中完全缓解的159例患者中113例妊娠患者作为妊娠组,46例未妊娠患者作为未妊娠组。所有患者予以高效孕激素醋酸甲羟孕酮口服治疗,通过单因素及多因素Logistic回归模型分析妊娠的影响因素。结果2组是否有妊娠史(χ2=3.416,P=0.065)、不孕症史(χ2=0.060,P=0.807)及合并肿瘤家族史(χ2=0.077,P=0.781)比较,差异无统计学意义;妊娠组具备妊娠条件(年龄)(χ2=49.343,P<0.001)、不是复发型(χ2=72.054,P<0.001)以及采用助孕技术(χ2=55.350,P<0.001)占比均高于未妊娠组,差异有统计学意义。多因素Logistic回归分析结果显示,不具备妊娠条件(年龄)(OR=15.818,95%CI为6.674~37.505,P<0.001)、复发(OR=31.624,95%CI为12.480~80.137,P<0.001)和未采用助孕技术(OR=17.968,95%CI为7.669~42.099,P<0.001)是影响子宫内膜癌患者经高效孕激素治疗后妊娠的危险因素。结论子宫内膜癌患者经高效孕激素治疗的效果较确切,不具备妊娠条件(年龄)、复发和未采用助孕技术是影响子宫内膜癌患者经高效孕激素治疗后妊娠的危险因素,临床应采取相应的措施,提高治疗后妊娠率。

Objective This study was to explore the influencing factors of pregnancy in patients with endometrial cancer after high-efficiency progesterone treatment,so as to provide reference for clinical improvement of pregnancy rate.Methods Patients with endometrial cancer treated in First Affiliated Hospital of Henan University of Science and Technology from September 1,2018 to May 1,2020,were taken as research objects,among 159 patients with complete remission,113 pregnant patients were regarded as the pregnant group,and 46 non-pregnant patients were regarded as the non-pregnant group.All patients were treated with efficiently progestational hormone medroxyprogesterone acetate orally,and the influcing factors of pregnancy were analyzed by single factor and multivariate Logistic regression.Results There was no significant difference in the history of pregnancy(χ2=3.416,P=0.065),infertility(χ2=0.060,P=0.807)and family history of tumor(χ2=0.077,P=0.781)between the two groups non pregnancy group,the difference was not statistically significant.The proportion of patients with pregnancy conditions(age)(χ2=49.343,P<0.001),non relapse(χ2=72.054,P<0.001)and the use of assisted pregnancy technology(χ2=55.350,P<0.001)in the pregnancy group were higher than those in the non pregnancy group,and the difference was statistically significant.Multiple Logistic regression analysis showed that lack of gestational conditions(age)(OR=15.818,95%CI:6.674-37.505,P<0.001),recurrence(OR=31.624,95%CI:12.480-80.137,P<0.001)and no use of assisted pregnancy technology(OR=17.968,95%CI:7.669-42.099,P<0.001)were risk factors for pregnancy in patients with endometrial cancer after high-efficiency progesterone treatment.Conclusions The effect of endometrial carcinoma patients treated with efficiently progestational hormone is more accurate.The lack of pregnancy conditions(age),recurrence,and the absence of assisted pregnancy techniques are the risk factors that affect the pregnancy of endometrial carcinoma patients after efficiently progestational hormone treatment.Corresponding measures should be taken to increase the pregnancy rate after treatment.