子宫内膜异位症患者术后自然妊娠的相关影响因素及其护理干预措施分析

Related factors of postoperative natural pregnancy in patients with endometriosis and analysis of nursing interventions

目的分析子宫内膜异位症患者术后自然妊娠的相关影响因素及其护理干预措施。方法回顾性收集2017年1月至2019年4月上海中医药大学附属曙光医院收治的子宫内膜异位症患者120例纳入研究,回顾性收集其临床资料,根据患者随访2年自然妊娠情况将其分为自然妊娠组89例和未妊娠组31例。比较2组的临床特征,通过多因素Logistic回归分析法分析子宫内膜异位症患者术后自然妊娠的相关影响因素。结果自然妊娠组年龄≥35岁(6.7%)、月经来潮持续时间<3 d(47.2%)、r-AFS分期Ⅲ~Ⅳ期(25.8%)、术后未应用GnRH-a治疗(15.7%)、有妇科炎症(47.2%)者比例低于未妊娠组(61.3%,74.2%,71.0%,71.0%,93.6%,P<0.05)。多因素Logistic分析结果显示,年龄≥35岁、月经来潮持续时间<3 d、r-AFS分期Ⅲ~Ⅳ期、术后未应用GnRH-a治疗、有妇科炎症是子宫内膜异位症患者术后不能自然妊娠的危险因素(OR=1.960,1.900,2.179,1.738,2.038,P<0.05)。结论年龄≥35岁、月经来潮持续时间<3 d、r-AFS分期Ⅲ~Ⅳ期、术后未应用GnRH-a治疗、有妇科炎症是子宫内膜异位症患者术后无法自然妊娠的危险因素,临床可通过加强患者个人卫生、维护月经周期、注重饮食状况等进行护理干预,并针对具备高危因素的患者进行强化女性生育健康宣教,以提高患者术后自然妊娠率。

Objective To analyze the related factors of postoperative natural pregnancy in patients with endometriosis and analysis of nursing interventions.Methods The clinical data of 120 patients with endometriosis were collected retrospectively,and they were divided into the natural pregnancy group(n=89)and the non-pregnancy group(n=31)according to the situation of natural pregnancy during 2-year follow-up.The clinical characteristics of the two groups were compared,and the related factors of postoperative natural pregnancy in endometriosis patients were ana-lyzed by multivariate Logistic regression analysis.Results In the natural pregnancy group,age≥35 years(6.7%),duration of menstruation<3 d(47.2%),r-AFS stageⅢ~Ⅳstage(25.8%),no postoperative gonadotropin-releasing hormone(GnRH-a)treatment(15.7%),with gynecological inflammation(47.2%)were lower than those in the non-pregnant group(61.3%,74.2%,71.0%,71.0%,93.6%,P<0.05).Multivariate Logistic analysis showed that age≥35 years,duration of menstruation<3 d,r-AFS stagingⅢ~Ⅳ,no postoperative GnRH-a treatment,gynecological inflammation were the risk factors for endometriosis patients(OR=1.960,1.900,2.179,1.738,2.038,P<0.05).Conclusion Age≥35 years,duration of menstruation<3 d,r-AFS stageⅢ~Ⅳ,no postoperative application of GnRH-a treatment,gynecological inflammation were not postoperatively in patients with endometriosis natural pregnancy risk factors.Clinical nursing intervention can be carried out by strengthening patients′personal hygiene,maintaining menstrual cycle and paying attention to diet,and strengthen female reproductive health education for patients with high risk factors can im-prove the rate of postoperative natural pregnancy.