宫腔粘连分离术后复发为重度宫腔粘连的因素分析

摘要

Objective:To investigate the risk factors of post-surgical recurrence of the intrauterine adhesion.Methods:In a prospective analysis,patients with intrauterine adhesion recurrence were divided into the non-severe group and severe group according to the severity of intrauterine adhesion diagnosed by hysteroscopy,and the clinical data of them were collected.The relevant risk factors were identified by multivariate logistic regression analysis.Results:295 patients with recurrent IUA from January 2015 to June 2016 were recruited in the study.The major factors affecting the outcomes were severe adhesion at the first hysteroscopic surgey,amenorrhea history and separation times of intrauterine adhesions OR =12.12 (95％ CI 5.30-27.7),OR =3.24 (95％ CI 1.60-6.57),OR =1.69 (95％ CI 1.11-2.58).Conclusions:Patients with severe adhesion or amenorrhea history have poorer outcomes after hysteroscopic adhesiolysis.Separation times of intrauterine adhesions is an increase risk of repeated intrauterine adhesion severity.%目的:探讨宫腔粘连(IUA)分离术后再次发生IUA且成重度粘连的危险因素.方法:前瞻性建立IUA复发患者的临床队列,根据美国生殖学会IUA评分标准分为非重度组和重度组,首先逐一分析可能相关的因素,然后对有统计学意义的因素进行多因素非条件Logistic回归分析.结果:2015年1月至2016年6月共295例复发性IUA患者参加研究.多因素分析发现初次发现IUA时为重度、刮宫后闭经史、多次IUA分离手术史者复发成重度粘连的风险明显增高,其OR值分别为12.12(95％CI 5.30 ～27.7),3.24(95％ CI 1.60～6.57),1.69(95％CI 1.11 ～2.58).结论:初次发现IUA时为重度或有刮宫后闭经史的患者行IUA分离手术后易复发为重度粘连;多次IUA分离也是IUA复发并成重度粘连的危险因素.