卵巢子宫内膜异位症剔除术后患者妊娠率及其影响因素分析

Analysis of Pregnancy Rate and its Influencing Factors in Patients after Ovarian Endometriosis Removal

【目的】探讨腹腔镜下卵巢子宫内膜异位症剔除术后患者妊娠率并分析其影响因素。【方法】选取2007年9月至2016年6月在本院妇科腹腔镜下卵巢子宫内膜异位囊肿剔除术的患者145例。根据患者卵巢子宫内膜异位病灶部位分为单侧组及双侧组,单侧组91例,双侧组54例。比较两组患者手术前、术后24 h及术后半年的促卵泡生成素（FSH）、雌二醇（E2）水平及患者的妊娠率,并探讨妊娠的影响因素。【结果】单侧组术后24 h、术后半年FSH、E2水平与术前比较差异均无统计学意义（P〉0.05）;双侧组术后24 h FSH水平较术前明显上升,且明显高于单侧组,E2水平较术前明显下降,且明显低于单侧组,其差异均有统计学意义（均P＜0.05）,术后半年FSH、E2水平恢复至术前水平。单侧组总妊娠率为56.04%（51/91）,明显高于双侧组33.33%（18/54）,其差异有统计学意义（P＜0.05）。患者妊娠与年龄、卵巢子宫内膜异位囊肿是单房或双房方有关,而与是否合并深部浸润型子宫内膜异位症、腹膜型子宫内膜异位症、子宫腺肌症及囊肿大小无关。【结论】卵巢子宫内膜异位症术后患者中单侧较双侧患者妊娠率更高,且患者年龄、卵巢子宫内膜异位囊肿是单房或双房在一定程度上影响患者妊娠。

【Objective】To observe the pregnancy rate of patients with ovarian endometriosis after laparoscopic surgery and to explore its influence factors.【Methods】One hundred and forty-five cases of laparoscopic ovarian endometriosis removal performed in our hospital were selected from September 2007 to June 2016.The lesions were divided into unilateral and bilateral groups according to the location of endometriosis in the patients, 91 cases in unilateral group and 54 cases in bilateral group. Follicle stimulating hormone （FSH）, estradiol （E2） levels and the pregnancy rate of patients of two groups of patients before surgery, postoperative 24 h and 6 onths post-operation were compared and the pregnancy influence factors were explored.【Results】There was no significant difference in the level of FSH and E2 in the unilateral group in postoperative 24 h and half year after operation （P〉0.05）; in the bilateral group, the FSH level of 24 h after surgery was significantly higher than that before surgery, and was significantly higher than that of the unilateral group.The level of E2 was significantly lower than that before operation, and significantly lower than that of unilateral group, and the differences were statistically significant （P〈0.05）.The level of FSH and E2 returned to the preoperative level after half a year.The total pregnancy rate of unilateral group was 56.04% （51/91）, which was significantly higher than that of the bilateral group 33.33% （18/54）, the difference was statistically significant （P〈0.05）; Pregnancy was associated with age and the factor whether ovarian endometriosis cysts were bilateral or unilateral, and was not related with Deep infiltrative endometriosis, peritoneal endometriosis, adenomyosis and cyst size.【Conclusion】The rate of pregnancy in patients with endometriosis is higher in unilateral than in bilateral patients.Pregnancy is associated with age and the factor whether ovarian endometriosis cysts are bilateral or unilateral.