【摘要】：目的:探討宮腔粘連(IUA)患者粘連程度的高危影響因素。方法:回顧2012年1月至2014年6月北京大學(xué)第三醫(yī)院生殖醫(yī)學(xué)中心經(jīng)宮腔鏡確診的493例IUA患者的臨床資料,根據(jù)粘連程度分組,分析影響粘連程度的相關(guān)因素。結(jié)果:不同粘連程度IUA患者的平均年齡、月經(jīng)周期和中孕妊娠丟失情況比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);不同粘連程度IUA患者的月經(jīng)量、原發(fā)不孕幾率、結(jié)核病史和內(nèi)膜炎情況均存在顯著差異(P0.05);隨著粘連程度的增加,經(jīng)量減少、原發(fā)不孕及結(jié)核病史的患者所占的比例逐漸增加,而合并內(nèi)膜炎患者的比例呈下降趨勢(shì)。IUA粘連程度與妊娠相關(guān)的宮腔操作有關(guān)(P0.05),隨著宮腔操作次數(shù)的增加,Ⅲ~Ⅴ度IUA患者明顯增加。41.48%的IUA患者的子宮內(nèi)膜超聲結(jié)果正常,不同粘連程度患者的超聲表現(xiàn)存在顯著差異(P0.001),但隨著粘連程度的加重,超聲確診粘連的比例無(wú)上升趨勢(shì)。444例Ⅰ~Ⅲ度IUA患者中,內(nèi)膜受損部位以中部居多,占45.05%;按粘連程度分組后,各組粘連部位存在統(tǒng)計(jì)學(xué)差異(P0.001),宮腔右側(cè)粘連的比例明顯高于左側(cè)。結(jié)論:積極治療感染性疾病,盡量減少宮腔創(chuàng)傷性操作,有助于避免IUA的發(fā)生;二維超聲診斷IUA的敏感性低,宮腔鏡檢查是診斷IUA的金標(biāo)準(zhǔn)。
[Abstract]:Objective: to investigate the high risk factors of adhesion degree in (IUA) patients with uterine cavity adhesion. Methods: the clinical data of 493 patients with IUA diagnosed by hysteroscopy from January 2012 to June 2014 were reviewed. The factors influencing the degree of adhesion were analyzed according to the degree of adhesion. Results: there was no significant difference in the average age, menstrual cycle and pregnancy loss of middle pregnancy among IUA patients with different degree of adhesion (P0.05). There were significant differences in menstrual volume, incidence of primary infertility, history of tuberculosis and endonitis among IUA patients with different adhesion levels (P0.05). With the increase of adhesion, the proportion of patients with primary infertility and tuberculosis history gradually increased, while the proportion of patients with endonitis decreased. The degree of IUA adhesion was related to pregnancy-related uterine cavity operation (P0.05), and the rate of IUA adhesion was related to pregnancy-related uterine cavity operation (P0.05). With the increase of the frequency of uterine cavity operation, the IUA patients with 鈪，

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