腹部子宫肌瘤切除术治疗不孕症。
Abdominal myomectomy in the treatment of infertility.
作者信息
Gehlbach D L, Sousa R C, Carpenter S E, Rock J A
机构信息
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
出版信息
Int J Gynaecol Obstet. 1993 Jan;40(1):45-50. doi: 10.1016/0020-7292(93)90771-n.
OBJECTIVE
To determine the effect of abdominal myomectomy as a treatment for infertility in women with uterine leiomyoma.
METHODS
Records were reviewed for 37 women at Johns Hopkins Hospital who underwent myomectomy as a primary procedure for infertility between 1975 and 1990.
RESULTS
Kaplan-Meier life-table analysis demonstrated a cumulative pregnancy rate of 57% and live birth rate of 48%. The size or number of myomas did not affect either the pregnancy rate or the myoma recurrence rate. The presence of pelvic adhesions at the time of myomectomy significantly reduced the chance of conception (P < 0.05). Adhesions were documented in 13 (68%) of 19 patients who underwent abdominal surgery at a later date.
CONCLUSIONS
Nearly half of the infertile women with uterine leiomyoma were able to bear children following abdominal myomectomy. Adhesion formation appears to be a common occurrence following myomectomy and reduces its effectiveness when present before surgery.
目的
确定腹部子宫肌瘤切除术对子宫肌瘤女性不孕症的治疗效果。
方法
回顾了约翰霍普金斯医院1975年至1990年间因不孕症接受子宫肌瘤切除术作为主要手术的37名女性的记录。
结果
Kaplan-Meier生存表分析显示累积妊娠率为57%，活产率为48%。肌瘤的大小或数量既不影响妊娠率也不影响肌瘤复发率。子宫肌瘤切除术时盆腔粘连的存在显著降低了受孕几率（P<0.05）。在19名后来接受腹部手术的患者中，有13名（68%）记录有粘连。
结论
近一半患有子宫肌瘤的不孕女性在接受腹部子宫肌瘤切除术后能够生育。粘连形成似乎是子宫肌瘤切除术后的常见情况，并且在手术前存在时会降低其有效性。
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