国际妇产科学杂志

国际妇产科学杂志 ›› 2014, Vol. 41 ›› Issue (5): 513-517.

• 论著 • 上一篇    下一篇

子宫动脉栓塞后宫腔粘连生殖预后分析——附26例报告

宋冬梅，夏恩兰，LI Tin-chiu，刘玉环，肖豫   

  1. 100038 北京，首都医科大学附属复兴医院宫腔镜诊治中心（宋冬梅，夏恩兰，LI Tin-chiu，刘玉环，肖豫）；英国谢菲尔德皇家哈勒姆郡医院妇产科，香港中文大学威尔士亲王医院妇产科（LI Tin-chiu）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-10-15 发布日期:2014-10-15

Analysis of the Reproductive Outcome of Intra-uterine Adhesiolysis for Asherman′s Syndrome Following UAE--a Report of 26 Cases

SONG Dong-mei，XIA En-lan，LI Tin-chiu，LIU Yu-huan，XIAO Yu   

  1. Hysteroscopic Center，Fuxing Hospital，Capital Medical University，Beijing 100038，China（SONG Dong-mei，XIA En-lan，LI Tin-chiu，LIU Yu-huan，XIAO Yu）；Department of Obstetrics and Gynaecology，Jessop Wing，Sheffield Teaching Hospitals and Sheffield Hallam University，Sheffield，S10 2SF，United Kingdom（LI Tin-chiu）；Department of Obstetrics and Gynecology，Prince of Wales Hospital，The Chinese University of Hong Kong，Shatin，New Territories，Hong Kong（LI Tin-chiu）
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-10-15 Online:2014-10-15

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摘要： 目的：探讨子宫动脉栓塞（uterine artery embolization，UAE）后宫腔粘连患者的生殖预后。方法：2008年5月—2014年3月首都医科大学附属复兴医院宫腔镜中心行宫腔镜下宫腔粘连分离术治疗UAE后患者26例，分析宫腔粘连分离术后美国生育学会（American Fertility Society，AFS）评分、月经恢复情况以及生殖预后。结果：仅38.5%（10/26）的患者术后月经较术前有改善；88.5%（23/26）的患者术后AFS评分较术前降低；26例患者中有2例自然妊娠，妊娠率7.7%，其中1例最终以妊娠早期胚胎停育而终止妊娠，另1例目前妊娠早期先兆流产，无1例活产。结论：UAE术后宫腔粘连的患者宫腔粘连分离术后生殖预后差，其原因可能与UAE后子宫血管灌注不良影响术后内膜再生有关。

关键词: 宫腔镜, 子宫内膜, 栓塞, 治疗性, 明胶海绵, 吸收性, 生育力, 子宫动脉栓塞

Abstract: Objective：To evaluate the reproductive outcome of hysteroscopic adhesiolysis in women who had Asherman′s syndrome following uterine artery embolization （UAE）. Methods：Hysteroscopic adhesiolysis （HA） was performed in 26 women with Asherman′s syndrome following UAE from May 2008 to March 2014. The changes in AFS score and menstrual pattern and reproductive outcome were analysed. Results：38.5% of women experienced improvement in menstruation defined as subjective increase in menstrual flow after surgery. The reduction of AFS score after HA was 88.5%. The spontaneous conception rate was 7.7%（2/26）, one of which experienced miscarriage in the first trimester. Another present symptom of threatened abortion at the last following up. Conclusions：The poorer outcome of hysteroscopic adhesiolysis in women with Asherman′s syndrome following UAE may be a consequence of compromised vascular supply to the endometrium adversely affecting regeneration after surgery.

Key words: Hysteroscopes, Endometrium, Embolization, therapeutic, Gelatin sponge, absorbable, Uterine artery embolization