子宫大小与宫腔粘连的相关性研究OA

Objective To explore correlation between uterine size and severity of intrauterine adhesions.Methods 726 patients who underwent hysteroscopy in Xiangyang No.1 People's Hospital from January 2018 to October 2023 were selected.337 patients who underwent hysteroscopic adhesiolysis were divided into intrauterine adhesions(IUA)group(study group),and 389 patients who underwent hysteroscopic metroplasty,hysteroscopic diagnostic curettage,hysteroscopy,and hysteroscopic intrauterine contraceptive device(IUD)removal in the same period were divided into control group.Multiple Logistic regression was used to analyze influencing factors of IUA.Spearman correlation analysis was used to analyze correlation between uterine size and IUA.Receiver operating characteristic(ROC)curve was used to analyze optimal threshold for occurrence of IUA.Results Compared with the control group,the patients in the IUA group had thinner endometrium,smaller uterine size and less IUD usage,as well as higher proportions of multigravid≥3 times,multipara≥3 times,multiple cesarean sections,frequent induced abortions≥3 times and history of induced delivery,the differences were significant(t/2=4.402-100.799,all P<0.05).Multivariate Logistic regression analysis showed that presence of IUD,thicker endometrium and larger uterine size were protective factors for IUA(OR=0.059-0.554,all P<0.05),while multigravid≥3 times,multipara≥3 times,frequent induced abortions≥3 times were risk factors for IUA(OR=2.106-3.217,all P<0.05).Uterine size decreased progressively with increase in degree of IUA from mild IUA,moderate IUA to severe IUA,and the differences were statistically significant(F=12.099,P<0.05).The uterine size was negatively correlated with varied severity of IUA,and this negative correlation increased progressively with increase in adhesion severity from mild IUA,moderate IUA to severe IUA(r=-0.584,-0.675 and-0.744 respectively,all P<0.05).The area under the curve(AUC)of uterine size for predicting risk of IUA was 0.775(95%CI:0.742-0.809),with a sensitivity of 66.5%,a specificity of 73.3%,and the optimal diagnostic cutoff value was 13.85 cm.The AUC of uterine size for predicting risk of moderate IUA and severe IUA was 0.650(95%CI:0.591-0.710),with a sensitivity of 48.1%,a specificity of 77.2%,and the diagnostic cutoff value was 12.75 cm.Conclusion Uterine size is associated with IUA,and with increase in uterine dimension,the severity of IUA becomes milder,while the correlation between diminutive uterus and severe IUA is more stronger.