摘要
目的探究不同程度宫腔粘连患者开展宫腔镜粘连分离术对后续复发及妊娠结局。方法选择2017年1月至2018年12月深圳市龙华区中心医院收治宫腔粘连患者120例,年龄21~40岁,平均年龄27.1岁;刮宫次数1~5次,平均刮宫次数2.8次;流产次数1~4次,平均流产次数2.5次;妊娠次数1~5次,平均妊娠次数2.6次。按照宫腔粘连程度不同分为3组,Ⅰ度40例(粘连累及至宫腔1/3)作为A组,Ⅱ度40例(粘连累及至宫腔1/3~2/3)作为B组,Ⅲ度40例(粘连累及至宫腔> 2/3)作为C组,所有患者均开展宫腔镜粘连分离术,比较治疗效果。结果治疗前,3组子宫内膜厚度、子宫体积、月经量差异无统计学意义(P> 0.05);治疗后,A组各项高于B组、C组,3组差异有统计学意义(P <0.05)。术后A组轻度粘连、中度粘连、重度粘连分别为2.50%、2.50%、0.00%,低于B组(10.00%、5.00%、5.00%)和C组(22.50%、17.50%、15.00%);3组比较,差异有统计学意义(P <0.05)。A组妊娠率、活产率分别为85.00%、55.00%,高于B组(62.50%、45.00%)和C组(42.50%、27.50%);3组比较,差异有统计学意义(P <0.05)。结论宫腔粘连程度越严重,患者预后越差,宫腔内操作次数增加往往会增加感染风险,影响患者生殖预后。
Objective To explore the effect of hysteroscopic adhesions separation on the subsequent recurrence and pregnancy outcomes in intrauterine adhesion patients with different degrees. Methods From January 2017 to December 2018, a total of120 intrauterine adhesion patients were enrolled, which aged 21-40 years old with mean age of 27.1 years old;curettage times was 1-5 times with mean time of 2.8;abortion times was 1-4 times with mean time of 2.5;pregnancy times was 1-5 times with mean time of 2.6. According to intrauterine adhesion degree, all of them were divided into 3 groups: 40 cases of Ⅰdegree(adhesion involved uterine cavity 1/3) as group A, 40 cases of Ⅱ degree(adhesion involved uterine cavity 1/3-2/3) as group B and 40 cases of Ⅲ degree(adhesion involved uterine cavity > 2/3) as group C. All patients performed hysteroscopic adhesion separation and treatment effect were compared. Results Before treatment, there was no significant difference in endometrial thickness, uterine volume and menstrual volume in 3 groups(P > 0.05). After treatment, each parameters in group A was significantly higher than those in group B and group C(P < 0.05). After operation, mild, moderate and severe adhesion in group A(2.50 %, 2.50 % and 0.00 %) were significantly lower than those in group B(10.00 %, 5.00 % and 5.00 %) and group C(22.50 %, 17.50 % and 15.00 %)(P < 0.05). The pregnancy rate and live birth rate in group A(85.00 %, 55.00 %) were significantly higher than those in group B(62.50 %, 45.00 %) and group C(42.50 %, 27.50 %)(P < 0.05). Conclusion It is demonstrated that prognosis is related to intrauterine adhesion degree, increased frequency of intrauterine operations elevated the risk of infection and affect the reproductive prognosis of patients.
作者
张惠玲
陈冀莹
黄海雁
ZHANG Hui-ling;CHEN Ji-ying;HUANG Hai-yan(Department of Gyne-cology,Longhua Central Hospital,Shenzhen 518110,Guangdong,China)
出处
《生物医学工程与临床》
CAS
2020年第3期302-305,共4页
Biomedical Engineering and Clinical Medicine
关键词
宫腔镜粘连分离术
不同程度
宫腔粘连
复发
妊娠结局
hysteroscopic adhesions separation
different degrees
uterine adhesions
recurrence
pregnancy outcome
作者简介
张惠玲(1966-),女,广东河源市人,本科,副主任医师,主要从事妇产科临床及计划生育工作。电话:18923877338。E-mail:szhl_118@163.com。
