胚物残留并发宫腔粘连的危险因素分析

Risk Factors of Intrauterine Adhesions Complicated with Retained Products of Conception

目的:探讨胚物残留(RPOC)患者并发宫腔粘连(IUA)的危险因素。方法:回顾性分析2014年10月—2019年10月于首都医科大学附属北京妇产医院行宫腔镜手术治疗的115例RPOC患者的临床资料。按照宫腔镜手术术中是否诊断为IUA将其分为IUA组(30例)和非IUA组(85例),分析RPOC患者并发IUA的危险因素。结果:单因素分析显示,2组RPOC时间大于2个月、有妊娠期宫腔操作、残留胚物有血流信号者所占比例差异有统计学意义(均P<0.05)。多因素Logistic分析结果显示,有妊娠期宫腔操作(OR=4.005,95%CI:1.077~14.895,P=0.038)及RPOC时间大于2个月(OR=3.378,95%CI:1.076~10.603,P=0.037)均是RPOC并发IUA的危险因素。结论:临床中应重视RPOC患者并发IUA的危险因素,采取适当的措施,避免不必要的妊娠期宫腔操作,可在妊娠结束2个月内治疗RPOC,以降低发生IUA的风险。

Objective:To investigate the risk factors of intrauterine adhesions(IUA)in patients with retained products of conception(RPOC).Methods:115 patients with RPOC who underwent hysteroscopic surgery from October 2014 to October 2019 in our hospital were recruited in this retrospective study.All patients were divided into IUA group(30 cases)and non-IUA group(85 cases),according to the existence of IUA in hysteroscopic surgery.The risk factors of RPOC complicated with IUA were analyzed.Results:Univariated analysis showed that there were statistically significant differences in the proportion of patients with RPOC duration>2 months,intrauterine operation during pregnancy,and RPOC blood flow signal between the two groups(all P<0.05).Multivariate Logistic analysis revealed that intrauterine operation during pregnancy(OR=4.005,95%CI:1.077-14.895,P=0.038)and RPOC duration longer than 2 months(OR=3.378,95%CI:1.076-10.603,P=0.037)were risk factors of IUA complicated with RPOC.Conclusions:In clinical practice,we should pay attention to the above risk factors of IUA in patients with RPOC,take appropriate measures to avoid unnecessary intrauterine operation during pregnancy and treat RPOC within 2 months after the end of pregnancy to reduce the risk of IUA.