宫腔镜下宫腔粘连分离术后患者妊娠情况调查分析  

Investigation and analysis of pregnancy in patients after transcervical resection of adhesion

作　　者：刘嘉[1] 司景革 齐歆[1] 苏琦[1] 闫硕[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：《临床和实验医学杂志》2018年第2期203-206,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市科技计划项目资助(D09050803570903)

摘　　要：目的分析宫腔粘连患者宫腔镜下宫腔粘连分离术后妊娠情况及相关影响因素。方法随访2014年9月至2016年9月102例有生育要求的宫腔粘连患者宫腔镜下宫腔粘连分离术后患者的妊娠情况,并回顾性分析患者临床资料,分析影响术后妊娠的相关因素。结果纳入研究的102例患者均完成随访。102例宫腔粘连患者术后,妊娠54例,妊娠率52.9%。其中,成功分娩32例,活产率59.3%,其中采取剖宫产26例(81.3%);待产5例,均孕12周以上;流产17例,流产率31.5%。流产患者中,晚期流产4例(23.5%),稽留流产10例(58.8%),胎盘异常3例(17.7%)。妊娠患者与未妊娠患者年龄、病程、粘连程度、复发情况、术后月经均存在显著性差异(P<0.05)。多因素Logistic回归分析显示,年龄、粘连程度、术后月经情况是影响宫腔粘连术后妊娠的独立危险因素。结论宫腔粘连患者宫腔镜下宫腔粘连分离术后妊娠率较高,年龄、粘连程度、术后月经情况是影响术后妊娠的主要因素。Objective To analyze the pregnancy status and related factors in patients with intrauterine adhesions.Methods The pregnant status of 102 patients after transcervical resection of adhesion in our hospital from September 2014 to September 2016 were retrospectively analyzed.The clinical data were analyzed retrospectively,and the related factors affecting postoperative pregnancy were analyzed.Results All of the102 intrauterine adhesions patients included in the study were followed up,and 54 cases of pregnancy,the pregnancy rate was 52.9%.Among them,32 cases were successfully delivered and the live birth rate was 59.3%.Cesarean section was taken up in 26 cases(81.3%).Five cases were expected to be pregnant for more than 12 weeks.Abortion was performed in 17 cases and abortion rate was 31.5%.In abortion patients,late abortion 4 cases(23.5%),missed abortion 10 cases(58.8%),3 cases(17.7%) placental abnormalities.The age,duration,adhesion,recurrence,postoperative menstruation between pregnancy and non-pregnant patients had significant difference(P < 0.05).Multivariate Logistic regression analysis showed that age,degree of adhesion and postoperative menstrual status were independent risk factors for pregnancy in patients after transcervical resection of adhesion.Conclusion Hysteroscopic hysteroscopy has a higher pregnancy rate.The age,degree of adhesion and postoperative menstrual status are the main factors influencing postoperative pregnancy.

关 键 词：宫腔粘连 宫腔粘连分离术 妊娠情况 影响因素 

分 类 号：R713.4[医药卫生—妇产科学]