宫腔粘连分解术后患者妊娠结局的影响因素分析  

Analysis of influence factors for pregnancy outcomes of hysteroscopic adhesiolysis

作　　者：秦琰[1,2] 王蔼明[1] 王明凯[1] 赵勇[1] 尹善德[1] 黄影[1] 付鑫[2] 高宏[2] 

机构地区：[1]海军总医院,北京100048 [2]内蒙古民族大学,通辽市028000

出　　处：《生殖医学杂志》2014年第9期748-753,共6页Journal of Reproductive Medicine

基　　金：国家"十二五"科技支撑计划项目(2012BAI32B05);国家自然科学基金项目(81000245;81370703);全军后勤科研课题(CHJ13J012)

摘　　要：目的探讨宫腔粘连分解术后患者妊娠结局的相关影响因素。方法回顾分析83例宫腔粘连患者的临床资料,对可能影响患者术后妊娠的相关因素进行单因素和多因素Logistic回归分析,包括年龄、病程、刮宫次数、粘连程度、手术方式、术后月经模式、术后内膜厚度、再粘连与否、术后治疗、活性内膜分布。结果术后总体月经改善率79.5%,总妊娠率为56.6%,活产率为61.7%。多因素Logistic回归分析结果表明,病程、粘连程度、术后内膜厚度是影响术后妊娠的独立因素。结论宫腔镜下宫腔粘连分解术是宫腔粘连的主要治疗手段,病程、粘连程度、术后内膜厚度是影响生殖结局的主要因素;在进行宫腔粘连分类的同时,评估宫腔内活性内膜的分布,可以更好地预测患者的生殖预后。Objective：To evaluate influence factors of pregnancy outcomes in the patients with hysteroscopic adhesiolysis.Methods：The data of 83 patients were retrospectively analyzed by univariate and multivariate Logistic regression.The influence factors were included age,course of disease,past history of curettage,severity of adhesion,surgical procedure,menstrual pattern,endometrial thickness,recurrence,ancillary treatment,and appearance of endometrial activity.Results：The improvement rate of menstrual symptoms was 79.5%,and the pregnancy rate and the live birth rate after operations were 56.6% and 61.7% respectively.The Logistic statistics showed that course of disease,severity of adhesion,and endometrial thickness were independent factors.Conclusions：Hysteroscopic adhesiolysis is a major treatment for intrauterine adhesions.The course of the disease,severity of adhesion,and endometrial thickness were the main influence factors of pregnancy outcomes in the patients with hysteroscopic adhesiolysis.Evaluating the status of endometrial activity would help to predict the reproductive outcome.

关 键 词：宫腔粘连 ASHERMAN综合征 妊娠率 生殖预后 影响因素 

分 类 号：Q492.6[生物学—生理学]