中重度宫腔粘连患者TCRA术后生殖预后分析

发布时间：2018-05-03 02:29

本文选题：宫腔粘连 + 妊娠率　；参考：《重庆医科大学学报》2017年04期

【摘要】：目的:分析506例中重度宫腔粘连(intrauterine adhesion,IUA)患者TCRA术后生殖预后现状。方法:收集从2011年1月至2014年12月首次在本院腔镜科行宫腔镜下宫腔粘连电切手术的506例中重度宫腔粘连患者的临床资料,分别统计中度、重度组患者术后妊娠率和活产率,成功妊娠者足月产、流产和早产比例,以及产时并发症发生情况。结果:(1)506例宫腔粘连患者(中度274例,重度232例),90.51%的患者出现月经量减少甚至闭经,重度组月经量减少、继发性不孕的发生率显著高于中度组,差异有统计学意义(P=0.000)。(2)共随访患者433例,随访率85.57%,有生育要求者406例(93.76%),总妊娠率57.64%(234/406)、总活产率34.98%(142/406)。其中中度组妊娠率67.11%(151/225)、活产率42.22%(95/225);重度组妊娠率45.86%(83/181)、活产率25.97%(47/181),重度组妊娠率和活产率均较中度组明显降低,差异有统计学意义(P=0.000,P=0.01)。(3)所有妊娠患者中足月产构成比46.58%,流产构成比32.05%,重度组足月产构成比低于中度组,流产构成比高于中度组,但统计学上无差异(P=0.466,P=0.198)。妊娠患者中出现产后出血、胎盘粘连、前置胎盘、胎盘植入共178例次,产后出血和胎盘粘连发生率高于前置胎盘和胎盘植入,重度组胎盘植入的发生明显高于中度组,差异有统计学意义(P=0.045)。结论:中度宫腔粘连术后生殖预后优于重度宫腔粘连。
[Abstract]:Objective: to analyze the reproductive prognosis after TCRA in 506 patients with moderate or severe intrauterine adhesion. Methods: the clinical data of 506 patients with moderate and severe intrauterine adhesions were collected from January 2011 to December 2014 for the first time in our hospital. The rate of term delivery, abortion and preterm delivery, and complications during delivery in successful pregnancies. Results the incidence of secondary infertility was significantly higher in the severe group than in the moderate group, and the incidence of secondary infertility was significantly higher in the severe group than in the moderate group. The difference was statistically significant (P < 0. 000) 433 patients were followed up. The follow-up rate was 85. 57. 406 patients with fertility requirement were involved in this study. The total pregnancy rate was 57.64%, and the total live delivery rate was 34. 98% 1422 / 406. Among them, the pregnancy rate in the degree group was 67.11 / 225, and the live birth rate was 42.22 / 225; in the severe group, the pregnancy rate was 45.86 / 883 / 181, and the live birth rate was 25.97 / 181. The pregnancy rate and the live birth rate in the severe group were significantly lower than those in the moderate group. The difference was statistically significant (P < 0. 000) in all pregnant women, the ratio of term labor composition was 46.58, the abortion composition ratio was 32.05, the term birth composition ratio of severe group was lower than that of moderate group, and the abortion composition ratio was higher than that of moderate group, but there was no statistical difference between them. There were 178 cases of postpartum hemorrhage, placental adhesion, placenta previa and placenta accreta in pregnancy. The incidence of postpartum hemorrhage and placental adhesions was higher than that of placenta previa and placenta accreta, and the incidence of placenta accreta in severe group was significantly higher than that in moderate group. The difference was statistically significant. Conclusion: the reproductive prognosis of moderate intrauterine adhesions is better than that of severe intrauterine adhesions.
【作者单位】：南京医科大学附属妇产医院腔镜科;浙江大学医学院附属妇产科医院;
【分类号】：R713.4

【相似文献】