[1]蔡兴苑 卢丹* 代荫梅 魏薇 盛洁 吴霞 郑萍 周琦.腹腔镜子宫肌瘤剔除术后影响患者妊娠结局的多因素分析[J].中国微创外科杂志,2015,15(9):768-772.
　Cai Xingyuan,Lu Dan,Dai Yinmei,et al.Multi Factor Analysis of Reproductive Outcomes After Laparoscopic Myomectomy[J].Chinese Journal of Minimally Invasive Surgery,2015,15(9):768-772.
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腹腔镜子宫肌瘤剔除术后影响患者妊娠结局的多因素分析()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
15
期数:
2015年9期
页码:
768-772
栏目:
临床论著
出版日期:
2015-09-20

文章信息/Info

Title:
Multi Factor Analysis of Reproductive Outcomes After Laparoscopic Myomectomy
作者:
蔡兴苑 卢丹* 代荫梅 魏薇 盛洁 吴霞 郑萍 周琦
（首都医科大学附属北京妇产医院妇科，北京100026）
Author(s):
Cai Xingyuan;  Lu Dan;  Dai Yinmei;  et al.
Department of Gynecology, Beijing Obstetrics and Gynecology Hospital of Capital Medical University, Beijing 100026, China
关键词:
腹腔镜子宫肌瘤剔除术; 妊娠; 影响因素
Keywords:
Laparoscopic myomectomy; Pregnancy; Influential factor
分类号:
R737.33
文献标志码:
A
摘要:
目的探讨腹腔镜子宫肌瘤剔除术后影响患者妊娠能力的相关因素。方法选择2011年1月~2014年1月在我院妇科进行腹腔镜子宫肌瘤剔除术并有生育要求204例，其中单发肌瘤133例，多发71例，观察患者术后宫内妊娠率、流产率、妊娠结局等情况，分析患者术后妊娠能力的影响因素。结果随访0.5~3.5年，单发子宫肌瘤剔除术后妊娠率为64.0% (73/114),活产率为45.6% (52/114)，流产率为14.9% (17/114)，异位妊娠率为3.5% (4/114)；多发子宫肌瘤剔除术后妊娠率为52.7% (29/55)，活产率为43.6% (24/55)，流产率为9.1% (5/55)，异位妊娠率为0，2组均无显著性差异(P＞0.05)。单因素分析结果显示，腹腔镜子宫肌瘤剔除术后妊娠率与患者年龄、肌瘤数目及肌瘤类型有关(P<0.05)，与BMI、盆腔粘连、肌瘤大小、术前宫腔形态及肌瘤是否复发无关(P>0.05)；多因素分析显示，年龄和肌瘤数目是腹腔镜子宫肌瘤剔除术后影响妊娠能力的危险因素（β=-0.344, OR=0.709, 95% CI: 0.606~0.829,P=0.000；β=0.228, OR=1.256, 95% CI: 0.995~1.585,P=0.051）。结论年龄和肌瘤数目是腹腔镜子宫肌瘤剔除术后患者妊娠的影响因素。
Abstract:
ObjectiveTo explore factors related to patients’ pregnancy after laparoscopic myomectomy.MethodsA total of 204 patients receiving laparoscopic myomectomy and with fertility demands from January 2011 to January 2014 in our hospital were observed, including 133 cases of solitary uterine fibroids and 71 cases of multiple uterine fibroids. The rate of postoperative intrauterine pregnancy, miscarriage, pregnancy outcomes, and other factors were observed. The influential factors affecting the pregnancy ability were analyzed.ResultsAfter 0.5-3.5 years of followup, the pregnancy rate, live birth rate, miscarriage rate, and ectopic pregnancy rate for solitary laparoscopic myomectomy were 64.0%（73/114）, 45.6%（52/114）, 14.9%（17/114）, and 3.5%（4/114）, while for laparoscopic multiple myomectomy were 52.7%（29/55）, 43.6%（24/55）, 9.1%（5/55）, and 0, respectively. There were no significant differences between the two groups in the aforementioned factors(P>005). The univariate analysis found that the pregnancy rate after laparoscopic myomectomy was correlated to age, number of fibroids, and types of fibroid (P<0.05), and unrelated to BMI, pelvic adhesions, fibroids size, preoperative uterine morphology, and tumor recurrence (P>0.05). The multivariate analysis showed that age and number of fibroids were risk factors affecting fertility (β=-0.344, OR=0.709, 95% CI: 0.606-0.829,P=0.000；β=0.228, OR=1.256, 95% CI: 0.995-1.585,P=0.051).ConclusionAge and number of fibroids are influential factors affecting the pregnancy ability in patients receiving laparoscopic myomectomy.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：北京市科委《首都临床特色应用研究》项目（项目编号：Z111107058811031）*通讯作者，Email：ludan1020@sohu.com
更新日期/Last Update: 2016-01-04