【摘要】：目的:黃體中期宮腔鏡檢查對宮腔粘連分離術(shù)后內(nèi)膜功能恢復(fù)的評估。方法:收集2009年10月至2014年3月在廣東省計劃生育�？漆t(yī)院宮腔鏡中心進行宮腔粘連分離術(shù)治療的宮腔粘連患者82例,術(shù)后于黃體中期(排卵后6~8天)行宮腔鏡復(fù)查,宮腔形態(tài)恢復(fù)正常者根據(jù)宮腔鏡下子宮內(nèi)膜血管的形態(tài)和腺體開口分為內(nèi)膜佳組與內(nèi)膜差組。比較兩組B超檢查內(nèi)膜厚度及分型,黃體中期血清雌二醇(E2)、孕酮(P)的水平,免疫組織化學(xué)技術(shù)檢測子宮內(nèi)膜雌激素受體(ER)、孕激素受體(PR)的表達,隨訪妊娠率及妊娠結(jié)局等。結(jié)果:1宮腔粘連分離術(shù)后復(fù)查宮腔形態(tài)滿意72例,其中,內(nèi)膜佳組49例,內(nèi)膜差組23例。2內(nèi)膜佳組排卵日、黃體中期B超檢查內(nèi)膜厚度分別為8.2±1.0 mm、8.0±0.8mm,較內(nèi)膜差組7.1±1.2mm、7.0±1.0mm明顯增加,差異均有統(tǒng)計學(xué)意義(P0.01);內(nèi)膜佳組排卵日A型內(nèi)膜率為24.5%(12/49),較內(nèi)模差組4.3%(1/23)明顯增加,差異有統(tǒng)計學(xué)意義(P0.05)。兩組患者黃體中期血E2、P水平比較差異均無統(tǒng)計學(xué)意義(P0.05)。內(nèi)膜佳組黃體中期子宮內(nèi)膜腺上皮ER表達及間質(zhì)PR表達均較內(nèi)膜差組增強,差異均有統(tǒng)計學(xué)意義(P0.05)。3內(nèi)膜佳組臨床妊娠率及足月分娩率分別為59.1%(29/49)、55.1%(27/49),內(nèi)膜差組分別為13.0%(3/23)、4.3%(1/23),兩組比較差異有統(tǒng)計學(xué)意義(P0.01)。結(jié)論:宮腔粘連分離術(shù)后黃體中期宮腔鏡內(nèi)膜血管及腺體檢查是一種較好的評估子宮內(nèi)膜功能恢復(fù)的方法,對預(yù)測妊娠結(jié)局有一定的價值。
[Abstract]:Objective: to evaluate the recovery of endometrial function after intrauterine adhesion separation by hysteroscopy. Methods: from October 2009 to March 2014, 82 patients with intrauterine adhesion were treated by hysteroscopy in the hysteroscopy center of Guangdong Provincial Family Planning Hospital. Hysteroscopy was performed in the middle luteal period (6 days after ovulation). Patients with normal uterine cavity shape were divided into two groups according to the morphology of endometrial blood vessels and glandular opening under hysteroscopy. The levels of serum estradiol (E2) and progesterone (P) in the middle luteal phase were compared between the two groups. The expression of estrogen receptor (ER),) and progesterone receptor (PR) in endometrial estrogen receptor (ER),) was detected by immunohistochemistry. Pregnancy rate and pregnancy outcome were followed up. Results: (1) 72 cases with satisfactory uterine cavity morphology were reexamined after separation of intrauterine adhesions, including 49 cases of good endometrium group and 23 cases of endometrial difference group. 2 the thickness of endometrium was 8.2 鹵1.0 mm,8.0 鹵0.8 mm by ultrasonography in mid-luteal phase on the day of ovulation. Compared with the endometrium difference group (7.1 鹵1.2 mm) and 7.0 鹵1.0mm, the difference was statistically significant (P0.01). The rate of type A endometrium was 24.5% (12 / 49) on the day of ovulation, which was significantly higher than that of the group of internal model difference (4.3%) (1 / 23) (P0.05). There was no significant difference in E2P levels between the two groups (P0.05). The expression of ER and PR in endometrial glandular epithelium in the middle luteal phase of the endometrium group was significantly higher than that in the endometrium difference group (P0.05). 3 the clinical pregnancy rate and term delivery rate in the endometrium group were 59.1% (29 / 49), respectively. 55.1% (27 / 49), 13.0% (3 / 23) and 4.3% (1 / 23) in endometriosis group, respectively. The difference between the two groups was statistically significant (P0.01). Conclusion: hysteroscopic endometrial vascular and glandular examination is a good method to evaluate the recovery of endometrial function after luteal adhesions separation and has certain value in predicting pregnancy outcome.
【作者單位】： 廣東省計劃生育專科醫(yī)院;
【基金】：廣東省計劃生育委員會科研立項(編號:20110215,20110102)
【分類號】：R713.4

【參考文獻】

相關(guān)期刊論文 前7條

1 申洪;免疫組織化學(xué)染色定量方法研究（Ⅲ）[J];中國組織化學(xué)與細胞化學(xué)雜志;1995年01期

2 劉玉環(huán);趙玉婷;蔣東橋;夏恩蘭;劉琳琳;宋冬梅;鄭杰;彭雪冰;;大劑量雌激素對中重度宮腔粘連預(yù)后的影響[J];山東醫(yī)藥;2012年12期

3 魏靜;王蕊;李春霞;羅曉燕;梁竹巍;姚路;;胚胎著床窗口期子宮內(nèi)膜宮腔鏡表現(xiàn)與內(nèi)膜整合素αⅤβ_3表達的關(guān)系[J];實用醫(yī)學(xué)雜志;2009年11期

4 馮苗;李素春;潘萍;劉標英;;以宮腔鏡手術(shù)為主的綜合治療在宮腔粘連性不孕中的應(yīng)用[J];生殖與避孕;2009年08期

5 趙靜;張瓊;李艷萍;;聯(lián)合子宮內(nèi)膜厚度和類型對體外受精-胚胎移植臨床結(jié)局的預(yù)測[J];生命科學(xué)研究;2012年05期

6 周云帆;楊波;胡祥;焦洪亮;周長輝;田毅;雷寧靜;谷晨熙;許予明;戴建武;關(guān)方霞;;經(jīng)血源性子宮內(nèi)膜間充質(zhì)干細胞的分離、培養(yǎng)與鑒定[J];中國組織工程研究與臨床康復(fù);2010年32期

7 管媚媚;劉暢浩;黃妙玲;姚婷婷;林少丹;陳R，

本文編號：2395184