不同宫腔粘连评分标准对宫腔粘连疾病预后的预测作用分析  

Predictive efficacy of different intrauterine adhesion(IUA) classification systems on the prognosis of patients with IUA

作　　者：孙冬华[1] 何援利[1] 张冬梅[1] 黄晓斌[1] 蔡慧华[1] 曾丽颖[1] 

机构地区：[1]南方医科大学珠江医院妇产科,广州510282

出　　处：《解放军医学杂志》2017年第5期439-444,共6页Medical Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金(81270658)~~

摘　　要：目的探讨不同评分标准对宫腔粘连(IUA)手术预后的预测作用。方法纳入2010年1月-2017年1月南方医科大学珠江医院诊断并治疗的IUA患者,选取其中随访2年的患者100例作为研究对象,分别采用March分类、AFS评分、ESGE评级和中国评分对其进行分级评估,进而比较不同评分标准对IUA术后2年内妊娠率、活产率及有效率的预测作用。结果 ESGE评级对IUA术后活产率和有效率有较好的预测作用,对妊娠率有一定的预测作用,其曲线下面积(AUC)分别为0.722、0.754、0.635;March分类对术后活产率、有效率有一定的预测作用,AUC分别为0.652、0.725,对妊娠率的预测效能不佳;AFS评分、中国分级评分对IUA预后的预测效能不佳。结论在预测IUA预后方面,ESGE评分优于March分类、AFS评分、中国评分,但仍需大样本研究进一步验证。Objective To explore the effects of different intrauterine adhesion （IUA） classification systems on predicting the IUA prognosis. Methods One hundred cases were selected as the subjects in present study from those diagnosed with IUA and underwent surgery in Zhujiang Hospital of Southern Medical University from Jan. 2010 to Jan. 2017, and were followed up for two years. According to the actual situation, all patients were scored by March, AFS, ESGE and Chinese classification for comparing the effects of different IUA classification systems on predicting the pregnancy rate, live birth rate and effective rate within 2 years after surgery. Results ESGE classification had a good effect on predicting the postoperative live birth rate and effective rate, and a certain predictive effect on pregnant rate, with the area under curve （AUC） of 0.722, 0.754 and 0.635, respectively. March classification had a certain effect on predicting the postoperative live birth rate and effective rate with AUC of 0.635, 0.754, respectively, but had a poor effect on predicting pregnant rate. AFS classification and China classification had poor effect on predicting the IUA prognosis. Conclusion ESGE classification system is better than the other systems including March, AFS and Chinese classification, on predicting the IUA prognosis, but further verification in large sample size is still required.

关 键 词：宫腔粘连 ASHERMAN综合征 评分标准 预后 

分 类 号：R711.5[医药卫生—妇产科学]