黄体中期宫腔镜检查对宫腔粘连分离术后内膜功能恢复的评估

发布时间：2018-12-29 18:07

【摘要】：目的:黄体中期宫腔镜检查对宫腔粘连分离术后内膜功能恢复的评估。方法:收集2009年10月至2014年3月在广东省计划生育专科医院宫腔镜中心进行宫腔粘连分离术治疗的宫腔粘连患者82例,术后于黄体中期(排卵后6~8天)行宫腔镜复查,宫腔形态恢复正常者根据宫腔镜下子宫内膜血管的形态和腺体开口分为内膜佳组与内膜差组。比较两组B超检查内膜厚度及分型,黄体中期血清雌二醇(E2)、孕酮(P)的水平,免疫组织化学技术检测子宫内膜雌激素受体(ER)、孕激素受体(PR)的表达,随访妊娠率及妊娠结局等。结果:1宫腔粘连分离术后复查宫腔形态满意72例,其中,内膜佳组49例,内膜差组23例。2内膜佳组排卵日、黄体中期B超检查内膜厚度分别为8.2±1.0 mm、8.0±0.8mm,较内膜差组7.1±1.2mm、7.0±1.0mm明显增加,差异均有统计学意义(P0.01);内膜佳组排卵日A型内膜率为24.5%(12/49),较内模差组4.3%(1/23)明显增加,差异有统计学意义(P0.05)。两组患者黄体中期血E2、P水平比较差异均无统计学意义(P0.05)。内膜佳组黄体中期子宫内膜腺上皮ER表达及间质PR表达均较内膜差组增强,差异均有统计学意义(P0.05)。3内膜佳组临床妊娠率及足月分娩率分别为59.1%(29/49)、55.1%(27/49),内膜差组分别为13.0%(3/23)、4.3%(1/23),两组比较差异有统计学意义(P0.01)。结论:宫腔粘连分离术后黄体中期宫腔镜内膜血管及腺体检查是一种较好的评估子宫内膜功能恢复的方法,对预测妊娠结局有一定的价值。
[Abstract]:Objective: to evaluate the recovery of endometrial function after intrauterine adhesion separation by hysteroscopy. Methods: from October 2009 to March 2014, 82 patients with intrauterine adhesion were treated by hysteroscopy in the hysteroscopy center of Guangdong Provincial Family Planning Hospital. Hysteroscopy was performed in the middle luteal period (6 days after ovulation). Patients with normal uterine cavity shape were divided into two groups according to the morphology of endometrial blood vessels and glandular opening under hysteroscopy. The levels of serum estradiol (E2) and progesterone (P) in the middle luteal phase were compared between the two groups. The expression of estrogen receptor (ER),) and progesterone receptor (PR) in endometrial estrogen receptor (ER),) was detected by immunohistochemistry. Pregnancy rate and pregnancy outcome were followed up. Results: (1) 72 cases with satisfactory uterine cavity morphology were reexamined after separation of intrauterine adhesions, including 49 cases of good endometrium group and 23 cases of endometrial difference group. 2 the thickness of endometrium was 8.2 卤1.0 mm,8.0 卤0.8 mm by ultrasonography in mid-luteal phase on the day of ovulation. Compared with the endometrium difference group (7.1 卤1.2 mm) and 7.0 卤1.0mm, the difference was statistically significant (P0.01). The rate of type A endometrium was 24.5% (12 / 49) on the day of ovulation, which was significantly higher than that of the group of internal model difference (4.3%) (1 / 23) (P0.05). There was no significant difference in E2P levels between the two groups (P0.05). The expression of ER and PR in endometrial glandular epithelium in the middle luteal phase of the endometrium group was significantly higher than that in the endometrium difference group (P0.05). 3 the clinical pregnancy rate and term delivery rate in the endometrium group were 59.1% (29 / 49), respectively. 55.1% (27 / 49), 13.0% (3 / 23) and 4.3% (1 / 23) in endometriosis group, respectively. The difference between the two groups was statistically significant (P0.01). Conclusion: hysteroscopic endometrial vascular and glandular examination is a good method to evaluate the recovery of endometrial function after luteal adhesions separation and has certain value in predicting pregnancy outcome.
【作者单位】：广东省计划生育专科医院;
【基金】：广东省计划生育委员会科研立项(编号:20110215,20110102)
【分类号】：R713.4

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