子宫肌瘤剔除术对不孕女性妊娠的影响及影响术后妊娠的相关因素分析

Analysis of the influence of uterine myomectomy on the pregnancy of infertile women and the related factors

目的:研究分析合并子宫肌瘤的不孕妇女行子宫肌瘤剔除术后的妊娠情况以及影响术后妊娠的原因。方法:随机选取宝鸡市中心医院2012年5月至2015年6月收治的子宫肌瘤剔除术患者150例,回顾分析所有受试者的一般资料、肌瘤特征以及术后随访情况。结果:根据随访1年～2年结果显示,患者的术后总妊娠率52. 0%(78/150),胎儿存活率69. 2%(54/78);根据Cox回归分析显示,术后妊娠的危险因子是年龄[RR=0. 99,95%CI(0. 98,1. 31),P <0. 05],与不孕种类、不孕时间、孕产史以及肌瘤的数量、大小、质地、种类都无关。结论:不孕兼有子宫肌瘤妇女行子宫肌瘤剔除术后可提高患者的妊娠率和胎儿存活率,年龄是术后妊娠的危险因子,这与妊娠率为负相关关系,因此患者可根据实际的年龄而决定是否行子宫肌瘤剔除术。

Objective ：To analyze the influence of uterine myomectomy on the pregnancy of infertile women with uterine fibroid and the related factors. Methods： 150 patients received uterine myomectomy in Baoji Central Hospital from May 2012 to June 2015 were selected randomly. The general information, characteristics and postoperative follow-up of these patients were retrospectively analyzed. Results ： According to the 1-2 year follow-up results, the total postoperative pregnancy rate and fetal survival rate was 52% （78/150） and 69.2% （54/78） respectively. According to the Cox regression analysis, age was the risk factors of postoperative pregnancy [ RR = 0. 99, 95% CI （0.98, 1.31 ）, P 〈 0. 05 ] , while the type of infertility, duration of infertility, pregnancy history and the number, size, texture and type of myoma was not. Conclusions： Uterine myomectomy can improve the postoperative pregnancy rate and fetal survival rate of infertile women with uterine fibroids and age is a risk factor, which is negatively correlated with postoperative pregnancy, so it should be decided according to the age of patients of whether to implement myomeetomy or not.