宫腔镜下子宫内膜息肉切除术后宫腔粘连影响因素分析

Analysis of Influencing Factors of Uterine Adhesion after Endometrial Polypectomy under Hysteroscopy

目的:探讨宫腔镜下子宫内膜息肉(EPs)切除术后宫腔粘连发生的影响因素。方法:选取320例在我院择期行EPs切除术的不孕患者为研究对象,222例未发生术后宫腔粘连为对照组,98例发生术后宫腔粘连为观察组。分析EPs切除术后宫腔粘连发生的影响因素,ROC曲线分析不同影响因素在预测EPs切除术后宫腔粘连发生中的效能。结果:校正混杂因素后,年龄≥35岁、糖尿病史、多发息肉、息肉直径>1 cm、合并子宫内膜异位症、孕次>1是术后宫腔粘连发生的独立危险因素(均P<0.05)。ROC曲线分析显示,年龄、糖尿病史、息肉个数、息肉直径、子宫内膜异位症和孕次预测息肉切除术后宫腔粘连发生的AUC分别为0.589、0.571、0.669、0.644、0.587和0.564。结论:宫腔镜下EPs切除术后宫腔粘连的发生与年龄、糖尿病史、息肉个数和直径、是否合并子宫内膜异位症和孕次有关。

Objective:To explore the influencing factors of intrauterine adhesion secondary to hysteroscopic endometrial polyps(EPs)resection.Methods:A total of 320 infertile patients who underwent elective EPs resection in our hospital were enrolled.There were 222 cases without postoperative intrauterine adhesion taken as the control group,and 98 cases with postoperative intrauterine adhesion taken as the observation group.The influencing factors of intrauterine adhesion secondary to EPs resection were analyzed.The ROC curve was used to analyze the efficacy of different influencing factors in predicting the occurrence of intrauterine adhesion secondary to hysteroscopic EPs resection.Results:After correction of confounding factors,age more than or equal to 35 years,diabetes history,multiple polyps,polyp more than 1 cm in diameter,endometriosis and pregnancy times more than 1 were independent risk factors of postoperative intrauterine adhesion(all P<0.05).In ROC curve analysis,AUC of age,diabetes history,polyp number,polyp size,endometriosis and pregnancy times were 0.589,0.571,0.669,0.644,0.587 and 0.564,respectively.Conclusion:The intrauterine adhesion secondary to EPs resection is related to the patient's age,history of diabetes,number and diameter of polyps,endometriosis and pregnancy times.