国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2017, Vol. 36 ›› Issue (4): 287-290.

• 论著 • 上一篇    下一篇

子宫内膜息肉合并不孕症患者术后自然妊娠率及其影响因素分析

栾雪峰，陈大立，侯文杰   

  1. 215006  苏州市立医院本部妇产科（栾雪峰，陈大立）；苏州大学附属第一医院妇产科（侯文杰）
  • 收稿日期:2017-04-26 修回日期:2017-06-15 出版日期:2017-07-15 发布日期:2017-07-15
  • 通讯作者: 侯文杰，E-mail：20094532015@suda.edu.cn E-mail:20094532015@suda.edu.cn
  • 作者简介:2017-08-01

Post-operation Spontaneous Pregnancy Rate and Its Influence Factors in Patients with Endometrial Polyps Associated Infertility

LUAN Xue-feng，CHEN Da-li，HOU Wen-jie   

  1. Gynecology and Obstetrics Department，Suzhou Municipal Hospital，Suzhou 215006，Jiangsu Province，China（LUAN Xue-feng，CHEN Da-li）；Gynecology and Obstetrics Department，The First Affiliated Hospital，Soochow University，Suzhou 215006，Jiangsu Province，China（HOU Wen-jie）
  • Received:2017-04-26 Revised:2017-06-15 Published:2017-07-15 Online:2017-07-15
  • Contact: HOU Wen-jie，E-mail：20094532015@suda.edu.cn E-mail:20094532015@suda.edu.cn

PDF (PC)

6045

摘要： 目的：分析子宫内膜息肉合并不孕症患者接受宫腔镜下子宫内膜息肉电切术（TCRE）治疗后的妊娠情况，同时研究各种因素对术后自然妊娠率的影响。方法：回顾性分析2012年1月—2015年1月因不孕且有生育要求而就诊于苏州市立医院本部，接受TCRE的女性患者的临床资料，以确诊为子宫内膜息肉的153例患者为研究对象。统计分析患者一般临床资料及手术情况，分析术后自然妊娠率及相关影响因素。结果：完成随访的153例患者中，共105例患者自然妊娠，总体妊娠率为68.63%。单因素分析显示，TCRE术后患者按照年龄、不孕年限、体质量指数（BMI）、不孕类型、既往宫腔操作次数、息肉生长部位、息肉数目、术后是否使用地屈孕酮分层后，自然妊娠率比较差异有统计学意义（均P＜0.05）。多因素Logistic回归分析结果显示：年龄大、BMI值高、息肉数目＞1个影响子宫内膜息肉患者TCRE术后妊娠率，而TCRE术后使用地屈孕酮治疗有利于提高患者自然妊娠（OR=3.719，95%CI：1.376～4.945）。结论：TCRE可显著提高子宫内膜息肉合并不孕症患者的术后自然妊娠率，是治疗子宫内膜息肉合并不孕症的有效手段。患者年龄、BMI、不孕类型和息肉数目为TCRE术后自然妊娠率的影响因素，而TCRE术后使用地屈孕酮周期治疗可显著提高患者术后自然妊娠率。

关键词:  子宫内膜, 息肉, 不育, 女（雌）性, 宫腔镜检查, 妊娠, 宫腔镜下子宫内膜息肉电切术

Abstract: Objective：To analyze the spontaneous pregnancy rate of infertility patients with endometrial polyps after transcervical resection of endometrium (TCRE), and the influence factors of postoperative spontaneous pregnancy rate. Methods：A retrospectively study was carried out on clinical data of 153 infertility EPs patients who were admitted to Suzhou Municipal Hospital from January 2012 to January 2015 and undertook TCRE. General clinical data, operation methods, postoperative natural pregnancy rate and related factors were analyzed. Results：105 cases got their spontaneous pregnancies, the overall pregnancy rate 68.63%. Univariate-analysis indicated that influence factors of postoperative spontaneous pregnancy rate were age, duration of infertility, BMI, infertility type, times of previous uterine cavity operation, polyp location, polyp number and progesterone treatment (P＜0.05). Multivariate Logistic regression analyses showed that the postoperative spontaneous pregnancy rate would decrease with higher age, higher BMI or more than one polyp, while progesterone treatment after TCRE would increase the spontaneous pregnancy rate (OR=3.719, 95%CI: 1.376～4.945). Conclusions：TCRE can improve the postoperative spontaneous pregnancy rate of infertile women with EPS. Age, BMI and polyp number were the main influencing factors of postoperative spontaneous pregnancy rate, while postoperative progesterone cycle therapy could significantly improve this rate.

Key words: Endometrium, Polyps, Infertility, female, Hysteroscopy, Pregnancy, Transcervical resection of endometrium