宫腔镜手术治疗Ⅱ型黏膜下子宫肌瘤术后宫腔粘连发生的相关因素分析  

Analysis of related factors of intrauterine adhesions after hysteroscopic surgery for typeⅡsubmucosal uterine fibroids

作　　者：范嫦妤 王佳丽 夏勤 FAN Changyu;WANG Jiai;XIA Qin(Department of Gynaecology,Fengcheng people's Hospital,Yichun,Jiangxi,331100,China)

机构地区：[1]丰城市人民医院妇科,江西宜春331100

出　　处：《当代医学》2024年第12期152-155,共4页Contemporary Medicine

摘　　要：目的分析宫腔镜手术治疗Ⅱ型黏膜下子宫肌瘤术后宫腔粘连(IUA)发生相关因素。方法选取2018年5月至2021年5月于丰城市人民医院接受宫腔镜电切黏膜下肌瘤手术治疗的80例患者作为研究对象,按照术后是否发生IUA分为对照组(未发生IUA,n=40)与研究组(发生IUA,n=40)。采用单因素和多因素Logistic回归分析影响宫腔镜下黏膜下肌瘤电切术后宫腔粘连的危险因素。结果两组年龄、文化程度、孕次、盆腔炎、产次、诊断性刮宫、节育环、子宫内息肉切除史、宫腔镜手术时间比较差异无统计学意义;两组流产、引产清宫、宫腔操作≥2次及剖宫产史比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,剖宫产史、宫腔操作≥2次、流产史、引产清宫史均为影响宫腔镜下黏膜肌瘤电切术后IUA的独立危险因素(OR>1,P<0.05)。结论宫腔镜下黏膜下肌瘤电切术后宫腔粘连的危险因素主要是医源性宫腔操作方面,临床需控制和预防危险因素以减少IUA的发生。Objective To analyze the related factors of intrauterine adhesions(IUA)after hysteroscopic surgery for typeⅡsubmucosal uterine fibroids.Methods A total of 80 patients who underwent hysteroscopic surgery of submucosal uterine fibroids in Fengcheng People's Hospital from May 2018 to May 2021 were selected as the research subjects,they were divided into the control group(without IUA,n=40)and the study group(with IUA,n=40)according to whether IUA occurred after operation.Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of intrauterine adhesions after hysteroscopic resection of submucous myoma.Results There was no significant difference in age,ed-ucational level,gravidity,pelvic inflammatory disease,parity,diagnostic curettage,birth control ring,history of intrauterine polyp resection and hys-teroscopic operation time between the two groups;there were significant differences in abortion,induced labor,uterine cavity operation≥2 times and cesarean section history between the two groups(P<0.05).Multivariate Logistic regression analysis showed that history of cesarean section,uterine cavity operation≥2 times,history of abortion,and history of induced labor were independent risk factors for IUA after hysteroscopic resection of mu-cosal myoma(OR>1,P<0.05).Conclusion The main risk factors of intrauterine adhesion after hysteroscopic surgery of submucosal uterine fi-broids are iatrogenic intrauterine operation,clinical risk factors need to be controlled and prevented to reduce the occurrence of IUA.

关 键 词：黏膜下肌瘤 宫腔镜电切术 宫腔粘连 宫腔操作 

分 类 号：R711.74[医药卫生—妇产科学]