不孕症患者临床情况与子宫内膜息肉的关系研究

The Relevance Analysis between Infertility and Endometrial Polyps

目的:探讨不孕症患者临床情况和子宫内膜息肉的关系,为临床诊治提供参考。方法:收集2008年11月至2009年10月间于本院行宫腹腔镜联合检查的244例不孕患者的临床资料,分别进行年龄、不孕年限、腹腔镜检查盆腔疾病和孕产史等与子宫内膜息肉发生的关系分析。同时分析B超检查与宫腔镜检查子宫内膜息肉的一致性。结果:不孕患者年龄、盆腔炎症情况在不同组别间子宫内膜息肉发生率差异无统计学意义(P均>0.05)。而不孕年限、孕产史以及子宫内膜异位症和子宫内膜息肉发生有关。随不孕年限增加,子宫内膜息肉发生率呈增高趋势(P=0.034),原发不孕组比继发不孕组子宫内膜息肉发生率高(15.71%vs5.8%,P=0.016),子宫内膜异位症组比无子宫内膜异位症组的子宫内膜息肉发生率高(19.0%vs7.5%,P=0.007)。宫腔镜检查子宫内膜息肉阳性率高于B超检查(11.5%与6.6%,P=0.000)。结论:子宫内膜息肉发生与不孕症患者不孕年限、病因、孕产史等因素相关,B超结合宫腔镜检查是排除内膜息肉有效手段。

Objective：To investigate the relevance between the clinical characteristics of female infertilityand endometrial polyps,and to provide the basis for clinical treatment of infertility. Methods： Clinical data of 244 infertility patients who had laparoscopy and hysteroscopy surgeries in the First Affiliated Hospital of Sun Yat-sen University from November 2008 to October 2009 were analyzed, including age, duration of infertility, laparoscopic pelvic disease and pregnancy history and the incidence of endometrial polyps. The diagnostic consistency of endometrial polyps by B-ultrasonic or by hysteroscopy was analyzed. Results： Patients＇ age and pelvic inflammatory diseases in different groups had no significant impacts on the incidence of endometrial polyps （P〉0.05）. But the duration of infertility, history of pregnancy and endometriosis were correlated with the incidence of endometrial polyps. With the elongation of duration of infertility, the incidence of endometrial polyps increased accordingly（ P =0.034）. The incidence of polyps in the primary infertility group was higher than that in the secondary infertility group（15.71% vs 5.8%, P=0.016）. Patients with endometrio- sis had a higher incidence rate of polyps than without endometriosis （19.0% vs 7.5%, P=0.007）. Hysteroscopy had higher positive rate of polyps than B-ultrasound （ 11.5% vs 6.6%, P = 0.000）. Conclusions. The incidence of endometrial polyps is correlated with the duration, causes of infertility and pregnancy history. Bultrasound combined with hysteroscopy is an effective method to exclude endometrial polyps.