| 茹晓莉 段华 王永军 于春梅 方芳.宫腔粘连发生和预后的相关因素研究[J].,2014,14(29):5712-5715 |
| 宫腔粘连发生和预后的相关因素研究 |
| Investigation of the Correlative Factors of Occurrence and Prognosisof Intrauterine Adhesions |
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| DOI： |
| 中文关键词: 中重度宫腔粘连 宫腔镜下宫腔粘连分离术 再粘连 疗效 宫腔粘连评分 |
| 英文关键词: Moderate to severe intrauterine adhesions Transcervical resection of intrauterine adhesions(TCRA) Readhesion Efficacy Intrauterine adhesions score |
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| 中文摘要: |
| 目的：探讨宫腔粘连发生的原因及宫腔粘连分离术后患者的妊娠结局的影响因素。方法：回顾性研究2005 年6 月至2010
年10 月间北京妇产医院收治的50 例中、重度宫腔粘连患者(研究组)及同期50 例单纯宫颈病变患者(对照组)，测量并计算两组的
子宫体积，分析宫腔粘连的病因，比较宫内节育器与Foley球囊用于预防术后宫腔再粘连的疗效，并随访患者的妊娠结局，分析其
与宫腔粘连分离术后二次探测宫腔粘连评分的相关性。结果：研究组子宫体积显著小于正常组，差异有非常显著的统计学意义
(P=0.001)。在50 例中、重度患者中，86%(43/50)患者为宫腔操作后继发的宫腔粘连；80%(40/50)有与妊娠相关的宫腔操作手术史
者。宫腔粘连分离术后，应用宫内节育器与Foley球囊用于预防术后宫腔再粘连，其宫腔评分、妊娠发生率及获活胎率比较均无统
计学差异(P>0.05)。宫腔粘连患者中，术后自然妊娠者宫腔粘连评分明显低于术后未妊娠者，妊娠获活胎者宫腔粘连评分显著低
于妊娠未获活胎者，差异均有统计学意义(P<0.05)。结论：子宫体积偏小与中、重度宫腔粘连的发生有关，其机理有待进一步探讨；
与妊娠相关的宫腔操作是宫腔粘连发生的高危因素；宫内节育器与Foley球囊用于预防术后宫腔再粘连的疗效相似；术后宫腔评
分与宫腔粘连患者的妊娠结局有一定的关系，可能作为宫腔粘连患者预后评估的参考指标。 |
| 英文摘要: |
| Objective:To investigate the causes of intrauterine adhesions and the influencing factors of pregnancy outcomes of
intrauterine adhesions patients after transcervical resection of intrauterine adhesions.Methods:50 cases of severe intrauterine adhesions
patients (study group) admitted fromJune 2005 to October 2010 in Beijing Obstetrics and Gynecology Hospital and 50 cases of cervical
lesions alone (control group) during the same period were retrospectively investigated. The uterine volume was measured and calculated;
the cause of intrauterine adhesions was analyzed; the IUD with Foley intrauterine balloon for the prevention of postoperative adhesions
efficacy were compared; and the patients' pregnancy outcomes was followed-up; the correlation of pregnancy outcomes with intrauterine
adhesions score in secondary detection was also analyzed.Results:The uterine volume of study group was significantly lower than that of
the normal group, (P=0.001). In 50 cases of moderate to severe patients, postoperative intrauterine adhesion was found in 86%(43/50) of
patients, intrauterine pregnancy surgical operation was associated with 80% (40/50) of patients. After transcervical resection of
intrauterine adhesions, IUD and intrauterine Foley balloon were applied for the prevention of postoperative adhesions,there was no
significant difference in the intrauterine adhesions score, pregnancy rate and living birth rate between the two groups (P>0.05). The
intrauterine adhesion-score of patients with postoperative natural pregnancy was significantly lower than that of non-pregnant; and
intrauterine adhesions score of living birth was significantly lower than that of pregnancy with on living birth (P<0.05).Conclusion:The
smaller uterine volume was related to the occurrence of intrauterine adhesions and the mechanismwas still needed to be further explored;
Uterine operation associated with pregnancy was a risk factor of the occurrence of intrauterine adhesions. There was similar efficacy
between IUD and Foley balloon for the prevention of postoperative intrauterine adhesions. Postoperative intrauterine adhesion score was
related to the pregnancy outcome and may be used as the prognostic indicator of intrauterine adhesions. |
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