本文選題：子宮內(nèi)膜異位癥 + 不孕癥��； 參考：《中國現(xiàn)代醫(yī)學(xué)雜志》2017年12期

【摘要】：目的觀察子宮內(nèi)膜異位癥(EMT)合并不孕癥患者接受開腹或腹腔鏡手術(shù)治療后的妊娠情況,并分析各種因素對術(shù)后自然妊娠率的影響。方法選取2011年1月-2014年1月因不孕并且有生育要求而就診于蘇州大學(xué)附屬第一醫(yī)院的女性患者的臨床資料,以確診為EMT的138例患者為研究對象。統(tǒng)計分析患者一般臨床資料及手術(shù)情況,分析術(shù)后自然妊娠率及相關(guān)影響因素。結(jié)果完成隨訪的138例患者中,45例患者自然妊娠,總體受孕率為32.61%,多因素Logistic回歸分析提示影響EMT患者術(shù)后自然妊娠率的相關(guān)因素為:年齡、不孕類型、臨床病理類型、修正子宮內(nèi)膜異位癥分期法(r-AFS)、術(shù)前抗穆勒氏管激素(AMH)和是否術(shù)后促性腺激素釋放激素類似物(Gn RH-a)治療,各因素間比較,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論手術(shù)可提高EMT不孕癥患者的術(shù)后自然妊娠率,是治療EMT不孕癥的有效手段,并且術(shù)后6~12個月自然妊娠率最大,是妊娠的最佳時機(jī),此后隨著時間的延長,妊娠率不斷下降�；颊吣挲g、不孕類別、臨床病理類型、r-AFS分期、術(shù)前AMH水平及術(shù)后是否使用Gn RH-a是影響EMT不孕癥患者術(shù)后自然妊娠率的重要因素。
[Abstract]:Objective to observe the pregnancy of patients with endometriosis combined with infertility after laparoscopy or laparoscopy, and to analyze the influence of various factors on the rate of spontaneous pregnancy after operation. Methods from January 2011 to January 2014, the clinical data of female patients who were hospitalized in the first affiliated Hospital of Suzhou University because of infertility and fertility requirement were selected. 138 patients diagnosed as EMT were selected as the study objects. The general clinical data and surgical conditions were analyzed, and the natural pregnancy rate and related influencing factors were analyzed. Results 45 cases of spontaneous pregnancy were followed up. The overall pregnancy rate was 32.61%. The multivariate Logistic regression analysis showed that the related factors affecting the spontaneous pregnancy rate of EMT patients were age, type of infertility, clinicopathologic type. There was a significant difference between the two groups in the treatment of endometriosis by modifying the staging of endometriosis by r-AFS, anti-Muller tube hormone (AMH) before operation and whether gonadotropin releasing hormone analogues (Gn RH-a) were treated after operation. There was significant difference between the two groups (P 0.05). Conclusion Operation can improve the rate of spontaneous pregnancy in patients with EMT infertility, and it is an effective method for the treatment of EMT infertility. The natural pregnancy rate is the largest in 6 ~ 12 months after operation, and it is the best time for pregnancy. After that, the pregnancy rate decreases continuously with the prolongation of time. Age, type of infertility, clinicopathologic type and r-AFS staging, preoperative AMH level and postoperative use of Gn RH-a were important factors influencing the spontaneous pregnancy rate in patients with EMT infertility.
【作者單位】： 蘇州大學(xué)附屬第一醫(yī)院婦產(chǎn)科;
【分類號】：R713.7

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