摘要
目的:探讨经阴道超声评估宫腔粘连(IUA)患者子宫内膜分型以及与妊娠结局的关系。方法:选取医院收治的158例IUA且术前和术后均行经阴道超声检查的已婚患者,根据是否妊娠将其分为妊娠组(109例)和非妊娠组(49例),比较两组患者术前、术后子宫内膜分型情况。结果:两组患者在年龄、不孕时限比较差异均有统计学意义(t=2.405,t=2.929;P<0.05),术后月经量增加、宫腔粘连程度、术前内膜分型以及术后内膜分型比较,差异均有统计学意义(χ^(2)=22.769,χ^(2)=10.97,χ^(2)=6.605,χ^(2)=73.534;P<0.05)。两组患者在体重指数、宫腔操作次数、流产次数的差异均无统计学意义。宫腔镜术前与术后子宫内膜分型的比较,妊娠组中A型内膜的数量由阴道超声下诊断为38例增长为术后阴道超声下的58例,B型内膜的数量由术前阴道超声下的53例减少为术后阴道超声下的40例,C型内膜由术前阴道超声下的18例减少为术后阴道超声下的11例,妊娠组中术前与术后子宫内膜分型比较差异有统计学意义(χ^(2)=39.422,P<0.05)。非妊娠组中A型由术前阴道超声下的15例增长为术后阴道超声下的18例,B型由术前阴道超声下的18例增长为术后阴道超声下的21例,C型由术前阴道超声下的16例减少为阴道超声下的10例,非妊娠组中术前与术后比较差异无统计学意义。宫腔镜手术治疗后,A型、B型内膜的妊娠率高于C型,A型与C型比较差异有统计学意义(χ^(2)=43.096,P<0.05)。结论:超声下观察子宫内膜的分型可以评估子宫内膜的容受性,有助于预测IUA患者的妊娠状况。超声检查对子宫内膜分型的观察,能较好的反应治疗前后内膜容受性的改变。
Objective:To explore endometrial somatotype of patients with intrauterine adhesion(IUA)by the assessment of transvaginal ultrasound and its relationship with pregnancy outcome.Methods:158 married patients with IUA who underwent transvaginal ultrasonography before and after operation were selected.They were divided into pregnant group(109 patients)and non-pregnant group(49 patients)according to whether they were pregnancy.The conditions of endometrial somatotype pre and post operation between two groups were compared.Results:There were significant differences in age and infertility duration between two groups(t=2.405,t=2.929,P<0.05),and there were significant differences in variates included the increase of menstrual blood volume,the degree of IUA,preoperative endometrial somatotype,and postoperative endometrial somatotype(χ^(2)=22.769,χ^(2)=10.97,χ^(2)=6.605,χ^(2)=73.534,P<0.05).The other variables included body mass index,the operation times in uterine cavity and the times of artificial abortion were not statistically significant between two groups.In the comparison of endometrial somatotype between pre and post operation with hysteroscopy,the number of type A of inner membrane increased to 58 cases under the postoperative transvaginal ultrasonography from the diagnosed 38 cases under the transvaginal ultrasonography,and the number of type B of inner membrane decreased to 40 cases from 53 cases and that of type C of inner membrane decreased to 11 cases from 18 cases in pregnant group,and the difference of endometrial somatotype between pre and post operation was significant(χ^(2)=39.422,P<0.05).In the non-pregnant group,the number of type A increased to 18 cases under postoperative transvaginal ultrasonography from 15 cases under preoperative transvaginal ultrasonography,and the number of type B increased to 21 cases from 18 cases,and that of type C decreased to 10 cases from 16 cases,and the difference of endometrial somatotype between pre and post operation was no significant.After the treatment of hysteroscopy,pregnancy rates of type A and type B were significantly higher than that of type C(χ^(2)=43.096,P<0.05).Conclusion:Endometrial somatotype under the observation with ultrasonography can assess the receptivity of endometrium,and it contributes to predict the pregnant condition of IUA patients.The observation of ultrasound examination on endometrial somatotype can preferably reflect the change of the receptivity of endometrium pre and post treatment.
作者
李品
陈萍
任敏
帅文
李碧岚
LI Pin;CHEN Ping;REN Min(Department of Ultrasound,Shanghai First Maternity and Infant Hospital Affiliated to Tongji University,Shanghai 200040,China)
出处
《中国医学装备》
2021年第12期68-72,共5页
China Medical Equipment
基金
上海市科学技术委员会科研项目(20ZR1443900)“CD28甲基化介导子宫内膜癌-免疫抑制型微环境T细胞对话机制的深入探讨”。
关键词
经阴道超声
宫腔粘连
子宫内膜分型
妊娠结局
Transvaginal ultrasound
Intrauterine adhesion(IUA)
Endometrial somatotype
Pregnancy outcome
作者简介
李品,女,(1985-),硕士,主治医师,从事临床超声诊断及研究工作;通信作者:陈萍,mellonping@51mch.com。
