基于倾向性评分匹配方法探讨子宫体积与宫腔粘连发生的相关性  

Correlation between uterine volume and intrauterine adhesion:a propensity score matching analysis

作　　者：许阡 段华[1] 安圆圆 甘露[1] Xu Qian;Duan Hua;An Yuanyuan;Gan Lu(Gynecological Minimally Invasive Center,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院,北京妇幼保健院妇科微创中心,北京100006

出　　处：《中华妇产科杂志》2025年第1期18-23,共6页Chinese Journal of Obstetrics and Gynecology

基　　金：国家重点研发计划(2018YFC1004803)。

摘　　要：目的研究子宫体积与子宫内膜损伤所致宫腔粘连之间的相关性。方法回顾性收集2018年6月至2019年11月期间于首都医科大学附属北京妇产医院妇科微创中心门诊所有行宫腔镜检查的7007例育龄期患者的临床资料,选取无子宫肌瘤、子宫腺肌病的宫腔粘连患者为宫腔粘连组,同期无子宫肌瘤、子宫腺肌病的非宫腔粘连育龄期患者为对照组。采用SPSS 26.0软件对两组患者以倾向性评分匹配方法进行1∶1匹配,匹配变量包括年龄、身高、体重、体重指数(BMI)、孕次、产次、流产刮宫次数。比较两组患者子宫体积是否存在差异,并探讨子宫体积是否为宫腔粘连的影响因素。另将宫腔粘连组患者分为轻度、中度、重度,探讨子宫体积是否影响宫腔粘连的严重程度。结果(1)本研究按入组标准共纳入宫腔粘连组患者351例,对照组患者2986例,经倾向性评分匹配,最终宫腔粘连组和对照组各327例患者,匹配后两组患者的年龄、身高、体重、BMI、孕次、产次、流产刮宫次数分别比较,差异均无统计学意义(P均>0.05)。(2)倾向性评分匹配后,宫腔粘连组患者的子宫体积中位数为44.23 cm^(3),对照组的子宫体积中位数为57.20 cm^(3),两组间子宫体积存在显著差异(P<0.001)。(3)子宫体积减小(OR=0.961,95%CI为0.952~0.970)是宫腔粘连形成的独立危险因素(P<0.001)。(4)子宫体积对宫腔粘连的严重程度有显著影响(P<0.001),子宫体积越大(B=-0.030,95%CI为-0.044~-0.017)宫腔粘连的严重程度越轻。结论子宫体积减小是宫腔粘连形成的独立危险因素,且子宫体积对于宫腔粘连的严重程度有显著影响,对于子宫体积较小的患者,应重视宫腔粘连的一级预防和二级预防。ObjectiveTo investigate the correlation between uterine volume and intrauterine adhesion(IUA).MethodsFrom June 2018 to November 2019,totally 7007 patients who underwent hysteroscopy in outpatient operating rooms of Gynecological Minimally Invasive Center,Beijing Obstetrics and Gynecology Hospital were retrospectively analyzed.Patients of reproductive age with IUA without uterine fibroids and adenomyosis were selected as IUA group,and patients of reproductive age without uterine fibroids and adenomyosis without IUA during the same period were selected as the control group.The propensity score matching(PSM)method was used to perform 1∶1 matching for the two groups of patients,matching variables included age,height,weight,body mass index(BMI),gravidity,parity,and number of abortion curettage.Whether there was any difference in uterine volume between the two groups of patients was compared,and whether uterine volume was an influencing factor of IUA was explored.The patients in IUA group were also categorized into mild,moderate and severe to explore whether uterine volume influenced the severity of IUA.Results(1)After inclusion and exclusion criteria,351 patients were included in IUA group and 2986 patients in the control group.With PSM,327 patients in IUA group and 327 patients in the control group were finally enrolled in this study.There were no statistically significant differences in age,height,weight,BMI,gravidity,parity,and number of abortion curettage between the two groups of patients after matching(all P>0.05).(2)After PSM,there was a significant difference between the uterine volume of IUA group(median:44.23 cm^(3))and the uterine volume of the control group(median:57.20 cm^(3);P<0.001).(3)Reduced uterine volume(OR=0.961,95%CI:0.952-0.970)was an independent risk factor for IUA(P<0.001).(4)Uterine volume had a significant effect on the severity of IUA(P<0.001),the larger the uterine volume(B=-0.030,95%CI:-0.044 to-0.017),the less severe the IUA.ConclusionsReduced uterine volume is an independent risk facto

关 键 词：宫腔粘连 子宫体积 相关性 危险因素 倾向性评分 宫腔镜检查 

分 类 号：R711.74[医药卫生—妇产科学]