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影响子宫内膜异位症相关性不孕患者腹腔镜治疗后妊娠结局的临床因素:一项回顾性研究。

Clinical factors influencing the pregnancy outcome after laparoscopic treatment in endometriosis-associated infertility patients: a retrospective study.

作者信息

Sindan Namita, Bhandari Adheesh, Sindan Namrata, Kc Rajan, Xia Erjie, Lin Yue

机构信息

Department of Gynecology and Obstetrics, Paropakar Maternity and Women's Hospital Kathmandu 00977, Nepal.

Department of Reproductive Center, The Second Affiliated Hospital of Wenzhou Medical University Wenzhou, Zhejiang, PR China.

出版信息

Am J Transl Res. 2021 Apr 15;13(4):2399-2409. eCollection 2021.

Abstract

INTRODUCTION

Endometriosis is an illness caused by the presence of foci of endometrial implants outside the uterine cavity. Laparoscopy (minimally invasive surgical method) is considered as the definitive treatment for Endometriosis.

METHOD

Clinical data from January 2014 till December 2018, between the ages of 20 and 40 years were collected. A total of 175 women with pelvic Endometriosis complicated with infertility, underwent laparoscopy in our hospital, were followed up to assess fertility outcome. We analyzed using univariate logistic regression analysis as well as multivariate logistic analysis.

RESULTS

We analyzed the relationship between them by logistic regression analysis. Univariate logistic regression analysis indicated that the significant factors for influencing pregnancy were the following factors: age, infertility types: primary or secondary infertility, treatment with Gonadotrophin Releasing Hormone-agonist, r-AFS grade, operative method: excision or ablation. And multivariate logistic regression using all the factors also revealed that age, infertility types: primary or secondary, treatment with GnRH-a, revised- American Fertility Society grading and operative method: excision or ablation were positively correlated and were the significant factors to influence pregnancy outcome. While the other factors such as Body Mass Index, and endometriosis along with other gynecological pathology were not statistically significant.

CONCLUSIONS

In this study, we found out that age, infertility type, treatment with Laparoscopy surgery, use of GnRH-a after the operation, grading of the disease, and different types of operative methods were found to be significant and were found to be the factors which influenced the pregnancy outcome.

摘要

引言

子宫内膜异位症是一种由子宫腔外子宫内膜植入灶的存在引起的疾病。腹腔镜检查(微创外科手术方法)被认为是子宫内膜异位症的 definitive 治疗方法。

方法

收集 2014 年 1 月至 2018 年 12 月期间年龄在 20 至 40 岁之间的临床数据。共有 175 名患有盆腔子宫内膜异位症合并不孕症的妇女在我院接受了腹腔镜检查,并进行随访以评估生育结局。我们使用单因素逻辑回归分析以及多因素逻辑分析进行分析。

结果

我们通过逻辑回归分析分析了它们之间的关系。单因素逻辑回归分析表明,影响妊娠的重要因素有以下几点:年龄、不孕类型:原发性或继发性不孕、促性腺激素释放激素激动剂治疗、r-AFS 分级、手术方法:切除或消融。使用所有因素进行的多因素逻辑回归也显示,年龄、不孕类型:原发性或继发性、GnRH-a 治疗、修订后的美国生育协会分级和手术方法:切除或消融呈正相关,是影响妊娠结局的重要因素。而其他因素如体重指数以及子宫内膜异位症合并其他妇科病理情况则无统计学意义。

结论

在本研究中,我们发现年龄、不孕类型、腹腔镜手术治疗、术后 GnRH-a 的使用、疾病分级以及不同类型的手术方法是显著的,并且是影响妊娠结局的因素。

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