宫腔镜下子宫内膜息肉切除术对妊娠结局相关影响

Analysis of pregnancy outcomes and related factors of women after hysteroscopic endometrial polypectomy

目的:分析宫腔镜下子宫内膜息肉切除术后妊娠结局及相关影响因素。方法:选取本院近两年收治的行宫腔镜下子宫内膜息肉合并不孕患者225例,均宫腔镜引导下行子宫内膜息肉切除术,随访24个月统计术后妊娠结局。结果:术后24个月患者的正常分娩率(21.3%)高于术后12个月(13.3%),自然妊娠率(24.0%)高于术后12个月(20.0%)(P<0.05)。多因素logistic回归分析提示,年龄≥30岁、息肉≥2个、息肉直径≥1cm、息肉部位在后壁或宫角、体质指数≥28kg/m^2、糖尿病史及继发性不孕等均可影响术后妊娠结局(P<0.05)。结论:宫腔镜下息肉切除术治疗子宫内膜息肉疗效与妊娠结局较好,术后24个月妊娠效果和自然分娩率更佳,患者的年龄、息肉个数、息肉直径、息肉部位、体质指数、糖尿病史、不孕类型等影响术后妊娠结局。

Objective:To analyze pregnancy outcomes and related factors of women after hysteroscopic endometrial polypectomy.Methods:225 infertility women with endometrial polyps were selected and were given hysteroscopic endometrial polypectomy in the past two years.The pregnancy outcomes of these women in 12 and 24 months after operation were analyzed.Results:The normal delivery rate and the natural pregnancy rate(21.3%and 24.0%)of these women in the 24th month after surgery were significant higher than those(13.3%and 20.0%)of these women in the 12th month after surgery(P<0.05).Multivariate logistic regression analysis indicated that age≥30 years old,number of polyp≥2,polyp diameter≥1cm,polyp site in posterior wall or uterine corners,body mass index(BMI)≥28kg/m^2,history of diabetes and secondary infertility could influence postoperative pregnancy outcomes(P<0.05).Conclusion:Hysteroscopic polypectomy for treating women with endometrial polyps has good clinical effect and pregnancy outcomes,and the pregnant effect and natural delivery rate of women in 24 months after operation are better.Age,number of polyps,polyp diameter,polyp location,BMI,history of diabetes mellitus,and type of infertility influence the pregnancy outcomes.