不孕症合并子宫内膜异位症47例腹腔镜治疗术后疗效的影响因素分析

Analysis of the influence factors of curative effect of 47 cases of endometriosis-associated infertility after laparoscopic treatment

目的探讨腹腔镜治疗不孕症合并子宫内膜异位症的术后疗效的影响因素。方法选取2013年3月至2017年12月黄山市人民医院收治的47例不孕症合并子宫内膜异位症病人进行回顾性研究,统计并分析病人年龄、不孕年限、不孕类型、病理类型、r-AFS分期、EFI评分、术后用药、辅助生殖等因素与术后妊娠的关系。结果单因素分析显示妊娠组在年龄、术后是否规范用药、术后是否接受辅助生殖、EFI评分、不孕年限、不孕类型、病理类型和R-AFS分期等变量上与未妊娠组差异无统计学意义。根据临床、统计专家意见,选择P值较小(P<0.15)的因素进行多因素logistic回归分析,发现年龄≥35岁(χ^2=5.084,P=0.024)、EFI评分(χ^2=3.938,P=0.047)、术后是否规范用药(χ^2=4.293,P=0.038)、术后是否接受辅助生殖技术(χ^2=5.647,P=0.017)可以有效预测术后妊娠。结论年龄大小、EFI评分对不孕症合并子宫内膜异位症病人腹腔镜术后妊娠具有预测价值。术后规范用药、联合辅助生殖技术是提高妊娠概率的理想方法。

Objective To explore the influence factors of curative effect in the treatment of endometriosis-associated infertility by laparoscopy.MethodsFrom Mar 2013 to Dec 2017,47 patients,admitted to Huangshan City People’s Hospital,of endometriosis-associated infertility were studied retrospectively.The relationship between prognosis of pregnancy and age,infertility time,type of infertility,pathological types,r-AFS,EFI score,post-operative medication and assisted reproduction and other factors were analyzed.ResultsUnivariate analysis showed that there was no significant difference between the pregnant group and the non-pregnant group in age,post-operative medication,assisted reproduction,EFI score,infertility time,type of infertility,pathological types and R-AFS.According to the opinions of clinical and statistical experts,the factors with smaller p value(P<0.15)were selected for multivariate logistic regression analysis.We found that age≥35(χ^2=5.084,P=0.024),EFI score(χ^2=3.938,P=0.047),post-operative medication(χ^2=4.293,P=0.038)and assisted reproduction(χ^2=5.647,P=0.017)were effective predictors of post-operative pregnancy.ConclusionsAge and EFI score have predictive value for pregnancy after laparoscopy in patients with endometriosis-associated infertility.Standardized post-operative medication and assisted reproduction technology are ideal methods to improve pregnancy rate.