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目的评价与不孕相关的多种病史对术后妊娠结果的影响及预测术后妊娠的结果,确定适宜输卵管切开术的病例。方法选择1994-01-01-2003-06-01在中国医科大学附属盛京医院妇科腔镜中心行腹腔镜下输卵管切开术的96例输卵管阻塞的不孕症妇女(4例失访,不计入分析),分析其术后宫内妊娠(intrauterine pregnancy,IUP)和异位妊娠(ectopic pregnancy,EP)的发生情况。结果IUP和EP率分别为26.1%和15.2%,分析表明:有盆腔炎性疾病史(pelvic inflammatory disease,PID)、双侧均接受手术的患者与无此病史者有相似的IUP率,但EP率显著升高(P<0.05)。有宫内节育器(intrauterine device,IUD)使用史的妇女与无使用史者相比亦有相似的IUP率,但EP率明显降低(P<0.05)。逻辑回归模式预测术后EP率,显示IUD使用阳性史及单侧手术者其EP预期发生率显著低于有PID阳性史者。结论腹腔镜下输卵管切开术主要适用于既往有妊娠史和IUD使用史以及没有PID病史的患者。
Objective To evaluate the effect of multiple medical history related to infertility on the outcome of postoperative pregnancy and predict the outcome of postoperative pregnancy to determine the appropriate cases of tubal incision. METHODS: Ninety-six infertile women with tubal obstruction who underwent laparoscopic salvage surgery at the Gynecologic Endoscopy Center of Shengjing Hospital affiliated to China Medical University from January 1994 to January 2003 were retrospectively analyzed. Included in the analysis), analysis of intrauterine pregnancy (intrauterine pregnancy, IUP) and ectopic pregnancy (ectopic pregnancy, EP) incidence. Results The IUP and EP rates were 26.1% and 15.2%, respectively. The analysis showed that patients with pelvic inflammatory disease (PID) and bilateral surgery had similar IUP rates, but EP The rate was significantly higher (P <0.05). Women with a history of intrauterine device (IUD) also had similar IUP rates compared with those without history, but the EP rate was significantly lower (P <0.05). The logistic regression model predicts the postoperative EP rate, which shows that the IUD use positive history and the unilateral surgery patients’ EP expectation incidence rate is significantly lower than those with PID positive history. Conclusions Laparoscopic tubal incision is mainly applied to patients with past history of pregnancy and IUD use history and no history of PID.