子宫内膜异位症手术后妊娠情况及影响因素分析

Affecting pregnancy factors in patients with endometriosis after surgery

目的探讨子宫内膜异位症手术治疗后妊娠情况及影响因素。方法回顾性分析我院妇科2009年6月至2013年6月诊断明确的子宫内膜异位症伴不孕患者100例,所有患者均采用腹腔镜手术,利用问卷调查患者术后基本情况、手术情况,随访及分析患者妊娠情况和影响因素。结果患者术后随访1年,无失访。100例患者术后1年内正常受孕38例,妊娠率38.0%。不同年龄段、子宫内膜异位症分期、盆腔炎或手术史、输卵管阻塞、子宫良性病变、术后药物治疗、子宫内膜异位症生育指数(EFI)与子宫内膜异位症手术后妊娠有相关性(P<0.05);并经过Logistic回归分析,其中子宫内膜异位症分期、盆腔炎或手术史、输卵管阻塞、术后药物治疗、EFI得分等为影响患者术后妊娠的独立危险因素(P<0.05)。结论手术治疗明显提高患者妊娠率,其影响因素有子宫内膜异位症分期、盆腔炎或手术史、输卵管阻塞、术后药物治疗、EFI得分。

Objective： To investigate the pregnancy status and affecting pregnancy factors in patients with endometriosis after surgery. Methods： The data of 100 patients who were diagnosed endometriosis and received laparoscopic surgery in our hospital from June 2009 to June 2013 were retrospectively analyzed. All patients were inquired by a questionnaire for the basic status and the condition during and after operation to analyze the affecting pregnancy factors. Results. The patients were followed up for 1 year after surgery and 38 patients got pregnancy （38.0~）. The factors including age,the stage of endometriosis,pelvic inflammatory disease or surgery, tubal blockage, uterine benign lesions, postoperative medication, endometriosis fertility index （EFI）were significantly correlated with the pregnancy after surgery（P〈0.05）. The results of Logistic regression analysis found that the score of the stage of endometriosis, pelvic inflammatory disease or surgery, tubal obstruction, postoperative medication, EFI were the independent risk factors for pregnancy rate（P〈0.05）. Conclusions. Surgical treatment for patients with endometriosis significantly improves pregnancy rate. The affecting pregnancy factors are the stage of endometriosis, pelvic inflammatory disease or surgery, tubal obstruction, postoperative medication, EFI score.