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目的探讨不孕症妇女采用腹腔镜子宫肌瘤剔除术治疗后的妊娠影响因素。方法选取168例合并肌壁间或浆膜下子宫肌瘤的不孕症患者,所有患者均采用腹腔镜下行子宫肌瘤剔除术治疗,分析患者的年龄、术前不孕年限、宫腔形态以及肿瘤位置、数量和大小等因素与术后妊娠的相关性。结果 128(76.2%)例患者在术后3.5年内妊娠。22~29岁患者的术后妊娠率明显高于30~38岁患者(P<0.05)。肌瘤≤5 cm且数量<3个的患者术后妊娠率高于肌瘤>5 cm且数量>5个的患者(P<0.05)。术前子宫腔未变形患者的术后妊娠率高于术前子宫腔变形的患者(P<0.05)。子宫肌瘤位置紧邻子宫内膜的患者的妊娠率高于子宫肌瘤位置远离子宫内膜的患者(P<0.05)。结论子宫肌瘤剔除术后的妊娠率与患者的年龄、宫腔形态以及子宫肌瘤位置、数量和大小相关,术中矫正宫腔形态和子宫肌瘤的生长位置,可提高术后妊娠率。
Objective To investigate the influencing factors of pregnancy in infertile women after laparoscopic myomectomy. Methods A total of 168 infertile patients with intramural or submucous uterine fibroids were enrolled in this study. All patients underwent laparoscopic myomectomy. The patients’ age, prenatal period of infertility, uterine cavity morphology and tumor Location, number and size of factors such as the correlation with postoperative pregnancy. Results 128 (76.2%) patients were pregnant within 3.5 years after operation. The postoperative pregnancy rate was significantly higher in patients aged from 22 to 29 years (P <0.05). Patients with fibroids ≤ 5 cm and <3 had a higher pregnancy rate than those with> 5 cm fibroids and> 5 tumors (P <0.05). The preoperative pregnancy rate of uterine cavity patients was higher than that of preoperative uterine cavity patients (P <0.05). Patients with uterine fibroid close to the endometrium had a higher pregnancy rate than those with uterine fibroids distant from the endometrium (P <0.05). Conclusion The pregnancy rate after uterine myomectomy is related to the patient’s age, uterine morphology and the location, quantity and size of uterine fibroids. Intraoperative correction of uterine cavity morphology and uterine fibroids growth position can improve postoperative pregnancy rate.