黏膜下肌瘤与不孕：宫腔镜下子宫肌瘤切除术的效果及影响结局的因素
Submucous fibroids and infertility: Effect of hysteroscopic myomectomy and factors influencing outcome.
作者信息
Jayakrishnan K, Menon Vandana, Nambiar Divya
机构信息
Department of Minimally Invasive Surgery, KJK Hospital, Nalanchira, Chackai, Trivandrum, Kerala, India.
出版信息
J Hum Reprod Sci. 2013 Jan;6(1):35-9. doi: 10.4103/0974-1208.112379.
BACKGROUND
Submucosal myomas are associated with infertility and may be treated by hysteroscopic resection.
OBJECTIVE
The aim of this retrospective study was to analyze 37 subfertile patients who unnderwent hysteroscopic myomectomy in a tertiary care center with particular regard to their postprocedure reproductive outcome.
MATERIALS AND METHODS
The entire patient group (n = 37) underwent the procedure between March 2004 and March 2010. The submucosal myomas were type 0 (n = 27), type 1 (n = 8), and type 2 (n = 2). The mean myoma size was 2.1 cm; mean duration of the procedure was 54 mins and mean follow-up was 26 ± 10 months. 22 patients had one or more associated infertility factors.
RESULTS
The complication rate was 5.4%. 11 patients (29.7%) conceived after the procedure. The pregnancy rate was better when myoma was the exclusive etiology of infertility (40%), when the myoma was completely intracavitary (33.3%), when the lesion was ≥ 30 mm in size (50%), and there were no associated intramural fibroids.
CONCLUSION
Hysteroscopic myomectomy is a safe procedure to enhance fertility especially in cases with unexplained infertility.
背景
黏膜下肌瘤与不孕有关，可通过宫腔镜切除术治疗。
目的
这项回顾性研究的目的是分析在一家三级医疗中心接受宫腔镜子宫肌瘤切除术的37例不育患者，特别关注其术后生殖结局。
材料与方法
整个患者组（n = 37）在2004年3月至2010年3月期间接受了该手术。黏膜下肌瘤为0型（n = 27）、1型（n = 8）和2型（n = 2）。肌瘤平均大小为2.1 cm；手术平均时长为54分钟，平均随访时间为26±10个月。22例患者有一个或多个相关不孕因素。
结果
并发症发生率为5.4%。11例患者（29.7%）术后受孕。当肌瘤是不孕的唯一病因时（40%）、肌瘤完全位于宫腔内时（33.3%）、病变大小≥30 mm时（50%）以及无相关肌壁间肌瘤时，妊娠率更高。
结论
宫腔镜子宫肌瘤切除术是一种提高生育能力的安全手术，尤其是在不明原因不孕的病例中。
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