子宫内膜异位症不孕患者子宫内膜病变特征分析  

The characteristics of endometrial lesions in patients with endometriosis and infertility

作　　者：孙馥箐[1] 段华[1] 

机构地区：[1]首都医科大学附属北京妇产医院妇科微创中心,北京100006

出　　处：《中国计划生育和妇产科》2016年第7期49-53,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：国家自然科学基金资助项目(项目编号:81270680);北京市医院管理局临床医学发展专项资助项目("扬帆"计划;项目编号:zylx201406)

摘　　要：目的 研究子宫内膜异位症（endometriosis,EMs）不孕患者中子宫内膜病变的发生情况。方法 对2010~2014年首都医科大学附属北京妇产医院妇科微创中心490例因不孕症行宫、腹腔镜联合手术治疗患者的临床资料进行回顾性分析。将腹腔镜及病理证实的EMs患者131例纳入内异症组,将输卵管阻塞、积水、输卵管系膜囊肿、慢性盆腔炎及腹腔镜下盆腹腔无明显异常者359例纳入对照组。所有患者行宫腔镜全面探查宫腔,内膜病变由术后病理证实。对比两组患者内膜病变发生情况,并分析内异症组内膜病变的发生与内异症分期、病变部位、不孕症类型及患者年龄的相关关系。结果 1内异症组子宫内膜息肉发生率（42.75%）显著高于对照组（22.56%）,（P〈0.05）,内异症组子宫内膜增生症发生率（3.05%）略高于对照组（1.39%）,但差异无统计学意义（P〉0.05）;2 EMs不孕患者子宫内膜息肉发生率随着年龄增长而逐渐升高,呈明显的线性相关关系（P〈0.05）,36岁以上患者内膜息肉发生率是25岁以下患者的3.67倍;3EMs不孕患者子宫内膜息肉的发生与内异症分期、病变部位、不孕类型及不孕持续时间无关（P〉0.05）。结论 EMs相关不孕症患者子宫内膜息肉发生率明显升高,并随着年龄增长逐渐递增。Objective To investigate the characteristics of endometrial lesions in patients with endometriosis and infertility. Methods The clinical data of 490 patients with infertility hospitalized in Beijing Obstetrics and Gynecology Hospital affiliated of Capital Medical University between January 2010 and December 2014 were analyzed retrospectively. Patients with endometriosis confirmed by laparoscopy and pathology were assigned to the Endometriosis Group （ n = 131 ）, and patients without endometriosis were assigned to the Control Group （ n = 359 ）. All patients underwent hysteroscopy to uncover the state of the uterine cavity, and the state of endometrium was confirmed by postoperative patholog. Compared the endometrial lesions between two groups and analyzed the relationship between endometrial lesions in the Endometriosis Group and the stages of endometriosis, the location of endometriosis, thetype of infertility, and patients＇ age. Results （~） The incidence of endometrial polyps in the Endometriosis Group was significantly higher than that in the Control Group （42. 75 % vs. 22. 56 %, P 〈 0. 05 ）, but there is no significant difference in the incidence of endometrial hyperplasia between two groups （ 3.05 % vs. 1.39 % , P 〉 0. 05 ） ; （2） The incidence of endometrial polyps in the Endometriosis Group increased with age, and there was a linear correlation between the incidence of endometrial polyps and the patient age （ P 〈 0. 05 ）. The incidence of endometrial polyps in patients over 36 years of age was 3.67 - fold of patients under 25 years of age; （3） There is no relationship between the incidence of endometrial polpy and the stages of endometriosis, the location of endometriosis and the type of infertility in the Endometriosis Group （ P 〉 0. 05 ）. Conclusion The incidence of endometrial polyps in patients with endometriosis and infertility was significantly higher, and it increases with patients＇ age.

关 键 词：子宫内膜异位症 不孕症 子宫内膜息肉 子宫内膜增生症 

分 类 号：R711.71[医药卫生—妇产科学]