50例结核性宫腔粘连手术效果及妊娠结局分析

发布时间：2018-04-25 13:09

本文选题：女性生殖器结核 + 宫腔粘连　；参考：《现代妇产科进展》2017年09期

【摘要】：目的:回顾性分析50例结核性宫腔粘连患者经宫腔镜下粘连分离术后宫腔形态、月经恢复情况及生育结局。方法:选取2007年1月至2016年6月就诊于中南大学湘雅三医院妇科的50例结核性宫腔粘连患者,患者均予规范抗结核治疗6~9月后行宫腔粘连分离术,观察患者术后经量、宫腔形态及生育结局。采用Logistic回归对术后经量及宫腔形态恢复情况进行相关影响因素分析。采用四格表Fisher确切概率法分析术后经量及宫腔形态与妊娠的相关性。结果:50例患者中20例恢复正常月经,26例宫腔形态恢复至正常或接近正常。IVF-ET术后6例妊娠,其中2例早期流产,4例成功分娩获得活产儿。Logistic回归分析显示,抗结核治疗后的经量影响患者最终经量的恢复(P0.05);宫腔粘连程度及抗结核治疗后经量共同影响宫腔形态恢复(P0.05)。经量恢复正常的患者妊娠率(6/19,31.6%)明显高于经量未恢复正常的患者(0%)(P0.05);宫腔形态恢复正常的患者妊娠率(6/25,24%)明显高于宫腔形态未恢复正常的患者(0%)(P0.05)。结论:结核性宫腔粘连患者粘连分离术后经量及宫腔形态恢复欠佳,生育结局差。宫腔粘连分离术能给部分患者带来生育希望,但结核的预防及早期治疗才能减少甚至避免不孕及后续手术治疗。
[Abstract]:Objective: to retrospectively analyze the uterine cavity morphology, menstrual recovery and fertility outcome of 50 patients with tuberculous intrauterine adhesions after hysteroscopy. Methods: from January 2007 to June 2016, 50 patients with tuberculous intrauterine adhesions were selected from Xiangya third Hospital of Central South University. All patients were treated with standard anti-tuberculosis treatment for 6-9 months. Uterine cavity morphology and fertility outcome. The influence factors of postoperative menstrual volume and uterine cavity shape recovery were analyzed by Logistic regression. The correlation of postoperative menstrual volume and uterine cavity morphology with pregnancy was analyzed by Fisher method. Results among the 50 cases, 20 cases returned to normal menstruation and 26 cases got normal or close to normal. 6 cases were pregnant after .IVF-ET. Logistic regression analysis showed that 2 cases of early abortion and 4 cases of successful delivery of live infant. The volume of antituberculous therapy affected the final recovery of patients (P0.05A), and the degree of intrauterine adhesion and the amount of anti-tuberculosis treatment affected the recovery of uterine cavity morphology (P0.05G). The pregnancy rate of patients with normal menstrual volume was significantly higher than that of patients with normal menstrual volume (P 0.05), and the pregnancy rate of patients with normal uterine cavity shape was significantly higher than that of patients with normal uterine cavity shape (P 0.05). Conclusion: the volume of adhesions and uterine cavity morphology in patients with tuberculous intrauterine adhesions after separation were poor, and the fertility outcome was poor. Separation of intrauterine adhesions can bring fertility hope to some patients, but the prevention and early treatment of tuberculosis can reduce or even avoid infertility and subsequent surgical treatment.
【作者单位】：中南大学湘雅三医院妇产科;
【分类号】：R713.4

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