宫腔粘连分离术后复发为重度宫腔粘连的因素分析  

Logistic Regression Analysis of the Risk Factors of Severe Intrauterine Adhesion Recurrence

作　　者：鲁静洁[1] 朱慧[1] 朱湘虹[2] 汤晓秋[2] 王慧焱[2] 胡娅莉[1] 

机构地区：[1]南京医科大学附属鼓楼临床医学院,江苏南京210008 [2]南京大学医学院附属鼓楼医院,江苏南京210008

出　　处：《实用妇产科杂志》2017年第10期751-754,共4页Journal of Practical Obstetrics and Gynecology

基　　金：中国科学院"干细胞与再生医学研究"战略性先导科技专项(编号:XDA01030505);江苏省重点研发计划(社会发展)项目(编号:BE2016612)

摘　　要：目的:探讨宫腔粘连(IUA)分离术后再次发生IUA且成重度粘连的危险因素。方法:前瞻性建立IUA复发患者的临床队列,根据美国生殖学会IUA评分标准分为非重度组和重度组,首先逐一分析可能相关的因素,然后对有统计学意义的因素进行多因素非条件Logistic回归分析。结果:2015年1月至2016年6月共295例复发性IUA患者参加研究。多因素分析发现初次发现IUA时为重度、刮宫后闭经史、多次IUA分离手术史者复发成重度粘连的风险明显增高,其OR值分别为12.12(95%CI 5.30~27.7),3.24(95%CI 1.60~6.57),1.69(95%CI 1.11~2.58)。结论:初次发现IUA时为重度或有刮宫后闭经史的患者行IUA分离手术后易复发为重度粘连;多次IUA分离也是IUA复发并成重度粘连的危险因素。Objective：To investigate the risk factors of post-surgical recurrence of the intrauterine adhesion. Methods：In a prospective analysis, patients with intrauterine adhesion recurrence were divided into the non-se- vere group and severe group according to the severity of intrauterine adhesion diagnosed by hysteroscopy, and the clinical data of them were collected. The relevant risk factors were identified by multivariate logistic regression analysis. Results：295 patients with recurrent IUA from January 2015 to June 2016 were recruited in the study. The major factors affecting the outcomes were severe adhesion at the first hysteroscopic surgey, amenorrhea his- tory and separation times of intrauterine adhesions OR = 12, 12 （ 95% CI 5. 30 - 27.7 ）, OR = 3. 24 （95% CI 1.60 -6.57）, OR = 1.69 （95% CI 1.11 -2.58）. Conclusions：Patients with severe adhesion or amenorrhea his- tory have poorer outcomes after hysteroscopic adhesiolysis. Separation times of intrauterine adhesions is an in- crease risk of repeated intrauterine adhesion severity.

关 键 词：宫腔粘连分离术 宫腔粘连 危险因素分析 

分 类 号：R711.32[医药卫生—妇产科学]