不同分度宫腔粘连患者宫腔镜术后辅助人工周期治疗的疗效及影响因素研究OA
Efficacy and Influencing Factors of Postoperative Adjuvant Artificial Cycle Therapy After Hysteroscopy in Patients with Different Degrees of Intrauterine Adhesions
目的 探讨不同分度宫腔粘连(IUA)患者在基于分度的分层人工周期治疗方案下的临床结局及其影响因素.方法 选取 2022 年 6 月至 2025 年 6 月河南省人民医院收治的 86 例 IUA 患者,所有患者均行宫腔镜下粘连分离术,术后均给予人工周期治疗,根据 IUA 分度标准将患者分为轻度组(32 例)、中度组(37 例)、重度组(17 例).比较三组患者的治疗有效率、月经恢复情况、宫腔容积改善情况及并发症发生率,并分析影响治疗效果的因素.结果 轻度组治疗有效率为 93.75%,中度组为 72.97%,重度组为 47.06%,三组比较差异有统计学意义(P＜0.05);轻度组月经恢复正常率高于重度组;轻度组术后子宫内膜厚度及宫腔容积改善值均高于中度组和重度组,中度组均高于重度组,差异均有统计学意义(P＜0.05);三组并发症发生率比较,差异无统计学意义(P＞0.05).单因素分析显示,IUA 分度、术前宫腔容积、术后用药依从性与治疗效果相关(P＜0.05);多因素 Logistic 回归分析显示,重度 IUA(OR=5.924,95%CI 1.789～19.693,P=0.003)、术后用药依从性差(OR=5.368,95%CI 1.795～16.052,P=0.002)与治疗无效独立相关.结论 在本中心采用的基于分度的术后人工周期辅助方案下,不同分度 IUA 患者的恢复结局存在差异,重度 IUA 及术后用药依从性差是影响治疗效果的独立相关因素.
Objective To investigate the clinical outcomes and influencing factors of patients with different degrees of intrauterine adhesions(IUA)under a degree-based stratified artificial cycle therapy regimen.Methods A total of 86 patients with IUA admitted to Henan Provincial People's Hospital from June 2022 to June 2025 were selected.All patients underwent hysteroscopic adhesiolysis and received postoperative artificial cycle therapy.According to the IUA grading criteria,the patients were divided into a mild group(32 cases),a moderate group(37 cases),and a severe group(17 cases).The treatment response rate,menstrual recovery,improvement in uterine cavity volume,and incidence of complications were compared among the three groups,and the factors influencing treatment efficacy were analyzed.Results The treatment response rate was 93.75%in the mild group,72.97%in the moderate group,and 47.06%in the severe group,and the difference among the three groups was statistically significant(P＜0.05).The rate of return to normal menstruation in the mild group was higher than that in the severe group.The postoperative endometrial thickness and the improvement in uterine cavity volume in the mild group were both higher than those in the moderate group and the severe group,and those in the moderate group were both higher than those in the severe group;the differences were all statistically significant(P＜0.05).There was no statistically significant difference in the incidence of complications among the three groups(P＞0.05).Univariate analysis showed that IUA grade,preoperative uterine cavity volume,and postoperative medication adherence were associated with treatment efficacy(P＜0.05).Multivariate Logistic regression analysis showed that severe IUA(OR=5.924,95%CI:1.789-19.693,P=0.003)and poor postoperative medication adherence(OR=5.368,95%CI:1.795-16.052,P=0.002)were independently associated with treatment failure.Conclusion Under the degree-based postoperative adjuvant artificial cycle regimen adopted at this center,recovery outcomes differ among patients with different degrees of IUA.Severe IUA and poor postoperative medication adherence are independent factors associated with treatment efficacy.
刘梁;杜晗;张潇月;靳君丽;刘广芝
河南省人民医院 妇科,河南 郑州 450000河南省人民医院 妇科,河南 郑州 450000河南省人民医院 妇科,河南 郑州 450000河南省人民医院 妇科,河南 郑州 450000河南省人民医院 妇科,河南 郑州 450000
宫腔粘连宫腔镜手术人工周期治疗分度疗效影响因素
intrauterine adhesionshysteroscopic surgeryartificial cycle therapygradingefficacyinfluencing factors
《临床研究》 2026 (4)
8-12,5
2023年度国家卫生健康委科学研究基金—河南省医学科技攻关计划省部共建项目(SBGJ202302012).
评论