不孕患者子宫内膜息肉的宫腔镜诊治临床分析

Clinical Analysis of Hysteroscopic Diagnosis and Therapyof Endometrial Polyps of Infertile Patients

目的:探讨不孕患者子宫内膜息肉(EP)发生的相关因素及宫腔镜下EP清除术对助孕效果的影响。方法:接受宫腔镜检查的不孕患者855例,其中EP患者202例(EP组),宫腔正常者653例(对照组)。分析年龄、体质量指数、不孕年限、不孕类型及合并症等与EP发生的相关性;采用宫腔镜术联合药物(三联疗法)治疗,分析术后助孕效果。结果:EP发病率为23.6%,原发不孕、不孕年限>5年者EP发病率增高,EP患者合并子宫内膜异位症、子宫肌瘤、月经稀发几率明显增高(P<0.05);患者接受"三联疗法"治疗后,经助孕后临床妊娠率与对照组比无差异(P>0.05)。结论:宫腔镜手术有助于提高EP检出率,联合药物治疗的"三联疗法"是治疗EP的有效方法。

Objective：To explore the related factors of endometrial polyps（EP） in the infertile patientsand the pregnancy outcomes after EP removed under hysteroscopy.Methods：A total of 855 infertility patientswho received the hysteroscopic examination was recorded,including 202 EP patients（EP group） and 653patients without EP（control group）.The relationship among the type of infertility,duration of infertility,bodymass index（BMI）,complications and EP was analyzed;and the pregnancy outcomes of the EP patients whoreceived the treatment of triple therapy were analyzed.Results：The overall incidence of the EP in the infertilepatients was 23.6%.The incidence of the EP was higher in the patients of primary infertility,the infertileduration 5 years,and combining endometriosis,hysteromyoma,oligomenorrhea（P0.05）.After removedthe EP,there was no difference of the pregnancy outcomes between the EP group and the control（P0.05）.Conclusion：Appropriately expanding hysteroscopic indications can help to increase the detection rate of EP.Hysteroscopy combining drugs（triple therapy） is an effective treatment of EP.