国际妇产科学杂志

国际妇产科学杂志 ›› 2017, Vol. 44 ›› Issue (4): 440-442.

• 论著 • 上一篇    下一篇

宫腔镜切除术治疗子宫内膜息肉的效果及影响术后自然妊娠状态的因素分析

田宗茹，刘少霞，全秀玲   

  1. 300350  天津市咸水沽医院妇产科
  • 收稿日期:2017-02-13 修回日期:2017-05-18 出版日期:2017-08-15 发布日期:2017-08-15

The Effect of Hysteroscopic Resection Endometrial Polyp and the Influence Factors of Natural Gestation after Surgery

TIAN Zong-ru, LIU Shao-xia, QUAN Xiu-ling   

  1. Department of Obstetrics and Gynecology, Tianjin Xian Shui Gu Hospital, Tianjin 300350, China
  • Received:2017-02-13 Revised:2017-05-18 Published:2017-08-15 Online:2017-08-15

PDF (PC)

6571

摘要： 目的：探讨宫腔镜切除子宫内膜息肉（endometrial polyp，EP）的疗效及影响术后自然妊娠状态的因素。方法：选取2013年2月—2014年11月在天津市咸水沽医院妇产科宫腔镜电切治疗的60例EP合并不孕患者为研究对象。术后3、6、18个月随访患者的阴道不规则出血、EP复发率、自然妊娠率，并分析影响患者术后自然妊娠的因素。结果：术后阴道不规则出血发生率为3.33%，EP复发率为1.67%。术后3个月累积自然妊娠率为28.33%，术后6个月累积自然妊娠率为50%，术后18个月累积自然妊娠率为65.00%。单因素分析结果显示，不同年龄EP患者宫腔镜术后自然妊娠率差异有统计学意义（P＜0.01）；不同不孕年限、不孕类型及息肉大小的EP患者宫腔镜术后自然妊娠率比较差异无统计学意义（P＞0.05）。多因素分析显示，年龄＞30岁是EP患者宫腔镜切除术后自然妊娠率的影响因素（OR=11.00，95%CI：4.108~29.454，P=0.000）；原发性不孕、不孕年限＞3年、息肉＞1 cm或多发则不是EP患者术后自然妊娠率的影响因素（P＞0.05）。结论：对于EP合并不孕的患者，宫腔镜治疗具有良好的治疗效果，且患者年龄越小术后自然妊娠的成功率越高。
   

关键词:  息肉, 子宫内膜肿瘤, 宫腔镜检查, 妊娠率, 影响因素

Abstract: Objective: To explore the effect of transcervical resection by hysteroscopy in the management of endometrial polyps and influencing factors in pregnancy. Methods: Sixty infertile patients due to endometrial polyps treated in our hospital from February 2013 to November 2014 were collected as research object. All patients were treated with hysteroscopic resection. 3 months, 6 months and 18 months of follow-up were made. The incidence rates of abnormal vaginal bleeding, recurrence rates, and spontaneous pregnancy rates were counted. Influence factors in spontaneous pregnancy rate of patients with endometrial polyps underwent transcervical resection were analyzed. Results: After surgery, the incidence rate of abnormal vaginal bleeding was 3.33%. The recurrence rate was 1.67%. Three months after surgery, the accumulated spontaneous pregnancy rate was 28.33%. Six months after surgery, the accumulated spontaneous pregnancy rate was 50.00%. Eighteen months after surgery, the accumulated spontaneous pregnancy rate was 65.00%. Single factor analysis showed the difference of spontaneous pregnancy rate of patients underwent surgery between ages was statistically significant(P＜0.01), the difference of spontaneous pregnancy rate of patients underwent surgery between duration of infertility, the kind of infertility, and polyp size were not statistically significant(P＞0.05). Logistic regression analysis showed age＞30 was the influence factor in spontaneous pregnancy rate of patients with endometrial polyps underwent transcervical resection (OR=11.00, 95%CI: 4.108-29.454, P=0.000). However, primary infertility, duration of infertility＞3 years, polyp size＞1 cm or more polyps did not influence spontaneous pregnancy of patients underwent surgery (P＞0.05). Conclusions: For infertile patients due to endometrial polyps, the hysteroscopic resection treatment had good therapeutic effect. The younger the age, the higher the spontaneous pregnancy rate after hysteroscopic surgery.

Key words: Polyps, Endometrial neoplasms, Hysteroscopy, Pregnancy rate, Influence factor