【摘要】 目的:分析输卵管远端病变不孕患者经腹腔镜手术治疗后获得自然妊娠的影响因素。方法:选择2019年9月～2021年4月因输卵管远端病变行腹腔镜治疗的不孕患者，统计临床资料，随访术后妊娠情况，分析可能影响腹腔镜手术后自然妊娠的因素。比较妊娠组、未妊娠组之间相关因素的差异。结果:纳入分析的输卵管远端病变患者腹腔镜术后自然妊娠率为39.58%。妊娠组术前输卵管梗阻数量少于未妊娠组，术中发现输卵管微小病变的比例高于未妊娠组(P<0.05)。多因素COX回归模型显示，术中发现输卵管微小病变是术后妊娠的独立影响因素(OR=3.171,95%CI:1.042～9.654,P<0.05)。结论:病变范围小、受损轻的输卵管远端病变不孕患者术后获益更大，术中注意识别输卵管微小病灶并进行处理，恢复输卵管伞端功能，可提高手术患者宫内妊娠率。更多还原

【Abstract】 Objective:To analyze the factors affecting spontaneous pregnancy in infertile patients with distal tubal lesion after laparoscopic surgery.Methods:Infertile patients with distal tubal lesion undergone laparoscopic surgery were included from September 2019 to April 2021.The clinical data were collected and pregnancy after laparoscopic surgery was followed up to analyze the factors potentially affecting spontaneous pregnancy after operation.Additionally, the differences of related factors between pregnant group and non-pregnant group were compared.Results:The natural pregnancy rate was 39.58% in patients with distal tubal lesions after laparoscopic surgery.The number of tubal obstruction before operation was less in pregnant group than in non-pregnant group, and the proportion of tubal micro-lesions found during operation was higher than that in non-pregnant group(all P<0.05).Multivariate COX regression model showed that discovery of small fallopian tube lesions during operation was an independent factor affecting postoperative pregnancy(OR=3.171,95% CI:1.042-9.654,P<0.05).Conclusion:Infertility patients of distal fallopian tube lesions with minor involvement and damage can benefit more after operation.It is important to identify and treat the minor fallopian tube lesions during surgery, and restore the function of tubal umbrella end, which can improve the intrauterine pregnancy of such victims.更多还原