宫腔镜下宫腔黏连分离术治疗中重度宫腔粘连疗效的影响因素分析  

Influencing factors of curative effect of hysteroscopic separation of intrauterine adhesions in the treatment of moderate to severe intrauterine adhesions

作　　者：蔡海瑜 郭宝芝 刘爱珍[1] 宋芷霜 丁俊珊 沈慧敏 Cai Haiyu;Guo Baozhi;Liu Aizhen;Song Zhishuang;Ding Junshan;Shen Huimin(Department of Gynecology,Zhengzhou Maternity Hospital Affiliated to Henan University,Zhengzhou Maternal and Child Health Care Hospital,Zhengzhou 450012,China)

机构地区：[1]河南大学附属妇产医院,郑州市妇幼保健院妇科,450012

出　　处：《中国实用医刊》2020年第18期29-32,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析宫腔镜下宫腔粘连分离术治疗中重度宫腔粘连疗效的影响因素。方法回顾性分析2017年1月至2019年11月于河南大学附属妇产医院接受治疗且完成至少1年随访的103例中重度宫腔粘连患者的临床资料,所有患者均根据宫腔镜检查结果确诊,并接受宫腔镜下宫腔粘连分离或电切术。根据临床疗效将103例患者分为无效组(21例)与有效组(82例),比较两组年龄、病程、术前月经状况、术前宫腔内操作次数、发病原因、宫腔粘连分度、宫腔粘连范围、宫腔粘连部位、术后雌孕激素用量的分布状况,采用多因素Logistic回归分析检验影响中重度宫腔粘连患者宫腔镜下宫腔粘连分离术后疗效的相关因素。结果无效组病程25~30个月、宫腔粘连分度5度、宫腔粘连范围>2/3的例数占比高于有效组,术后雌孕激素用量为大剂量的例数占比低于有效组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,病程(25~30个月)、宫腔粘连分度(5度)、宫腔粘连范围(>2/3)是影响中重度宫腔粘连患者宫腔镜下宫腔粘连分离术后疗效的危险因素(OR>1,P<0.05),术后雌孕激素用量(大剂量)则是保护因素(OR<1,P<0.05)。结论病程、宫腔粘连分度、宫腔粘连范围、术后雌孕激素用量与中重度宫腔粘连患者宫腔镜下宫腔粘连分离术后疗效具有密切关联。Objective To analyze the related factors affecting the curative effect of hysteroscopic adhesions separation in patients with moderate to severe intrauterine adhesions.Methods The clinical data of 103 patients with moderate and severe intrauterine adhesions who received treatment in Zhengzhou Maternity Hospital Affiliated to Henan University from January 2017 to November 2019 and completed at least 1 year of follow-up were retrospectively analyzed,all patients were diagnosed according to the results of hysteroscopy,and underwent hysteroscopic separation of intrauterine adhesions or electrosurgical resection.According to the clinical curative effect,the 103 patients were divided into invalid group(n=21)and effective group(n=82).The age,course of disease,preoperative menstrual status,frequency of intrauterine operation,cause of disease,degree of intrauterine adhesions,extent of intrauterine adhesions,location of intrauterine adhesions,and distribution of postoperative estrogen and progesterone were compared between the two groups.Multivariate logistic regression analysis was used to examine the related factors influencing the efficacy of hysteroscopic adhesions separation in patients with moderate to severe intrauterine adhesions.Results The proportion of patients with 25-30 months course of disease,5 degree of intrauterine adhesion and more than 2/3 of intrauterine adhesions in the invalid group was higher than that in the effective group,and the proportion of patients with high dose of estrogen and progesterone after operation was lower than that of the effective group(P<0.05).Multivariate logistic regression analysis showed that course of disease(25-30 months),degree of intrauterine adhesions(5 degrees)and range of intrauterine adhesions(>2/3)were the risk factors for the efficacy of hysteroscopic separation of intrauterine adhesions(OR>1,P<0.05),and the dosage of estrogen and progesterone(high dose)was the protective factor(OR<1,P<0.05).Conclusions The course of disease,degree of intrauterine adhesions,extent o

关 键 词：宫腔粘连 中重度 宫腔镜 宫腔粘连分离术 

分 类 号：R713.4[医药卫生—妇产科学]