宫腹腔镜下子宫肌瘤剥除术治疗子宫肌瘤不孕症的效果及对自然妊娠的影响

Efficacy of hysterolaparoscopic myomectomy on the infertility people with uterine fibroids and its effect on natural pregnancy

目的分析宫腹腔镜下子宫肌瘤剥除术治疗子宫肌瘤不孕症的疗效及对自然妊娠的影响。方法选定张家口市第一医院妇产科2020年4月至2022年4月就诊的100例子宫肌瘤不孕症患者,根据随机数字表法分为观察组和对比组,每组50例,对比组给予腹腔镜子宫肌瘤剥除术(LM)治疗,观察组给予宫腹腔镜下子宫肌瘤剥除术治疗,对比2组手术指标、并发症总发生率、术后1年自然妊娠率、宫内妊娠率、异位妊娠率、自然受孕时间、不良妊娠结局总发生率。结果观察组术中出血量低于对比组,观察组手术时间、肛门首次排气时间、住院时间均短于对比组,差异均具有统计学意义(P<0.05)。观察组并发症总发生率、异位妊娠率低于对比组,术后1年自然妊娠率、宫内妊娠率均高于对比组(62.00%、50.00%),差异均有统计学意义(P<0.05)。观察组自然受孕时间短于对比组,不良妊娠结局总发生率低于对比组,差异均有统计学意义(P<0.05)。结论宫腹腔镜下子宫肌瘤剥除术具有创伤性小、术后恢复快、并发症少等优点,可有效提高子宫肌瘤不孕症患者自然受孕率,改善妊娠结局。

Objective To analyze the efficacy of hysterolaparoscopic myomectomy on the infertility people with uterine fibroids and its effect on natural pregnancy.Methods A total of 100 infertility patients with uterine fibroids admitted in the Department of Obstetrics and Gynecology of Zhangjiakou First Hospital from April 2020 to April 2022 were recruited.They were randomly assigned into control group(n=50)and observation group(n=50).Laparoscopic myomectomy(LM)and hysterolaparoscopic myomectomy were performed in patients of the control group and the observation group,respectively.Surgical indicators,total incidence of complications,1-year postoperative natural pregnancy rate,intrauterine pregnancy rate,ectopic pregnancy rate,natural conception time,and total incidence of adverse pregnancy outcomes were compared between groups.Results The amount of intraoperative blood loss in the observation group was significantly less than that in the control group,and the operation time,the first anal exhaust time,and the length of stay in the observation group were significantly shorter than those in the control group(P<0.05).The total incidence of complications and ectopic pregnancy rate were significantly lower in the observation group than those in the control group,and 1-year postoperative natural pregnancy rate and intrauterine pregnancy rate(62.00%vs 50.00%)were significantly higher(P<0.05).Significantly shorter natural conception time and lower total incidence of adverse pregnancy outcomes were detected in the observation group than those in the control group(P<0.05).Conclusion Hysterolaparoscopic myomectomy has the advantages of less trauma,quick postoperative recovery and fewer complications,which can effectively improve the natural conception rate and pregnancy outcome of infertile patients with uterine fibroids.