中重度宫腔粘连术后患者妊娠失败的影响因素

Influencing factors of pregnancy failure in patients after moderate to severe intrauterine adhesions surgeries

目的:分析中重度宫腔粘连术后患者妊娠失败的影响因素。方法:回顾性分析2018年3月至2021年3月37例中重度宫腔粘连术后妊娠失败患者的临床资料,设为失败组。另选取同期37例中重度宫腔粘连术后妊娠成功患者,设为成功组。比较两组临床资料,采用多因素Logistic回归分析中重度宫腔粘连术后患者妊娠失败的影响因素。结果:失败组重度宫腔粘连占比、月经未恢复正常占比、体质量指数(BMI)≥30 kg/m^(2)占比和术后再粘连占比高于成功组,差异均有统计学意义(P<0.05);两组年龄、病程、手术时间、使用防粘连装置情况、手术方式和宫腔操作次数比较,差异均无统计学意义(P>0.05)。Logistic回归分析结果显示,重度宫腔粘连、月经未恢复正常、BMI≥30 kg/m^(2)和术后再粘连均为中重度宫腔粘连术后患者妊娠失败的独立危险因素(OR>1,P<0.05)。结论:重度宫腔粘连、月经未恢复正常、BMI≥30 kg/m^(2)和术后再粘连均为中重度宫腔粘连术后患者妊娠失败的独立危险因素。

Objective:To analyze influencing factors of pregnancy failure in patients after moderate to severe intrauterine adhesions surgeries.Methods:The clinical data of 37 patients with pregnancy failure after moderate to severe intrauterine adhesion surgeries admitted to this hospital from March 2018 to March 2021 were retrospectively analyzed,and they set as failure group.The clinical data of 37 patients with successful pregnancy after moderate to severe intrauterine adhesion surgeries were retrospectively analyzed,and they set as successful group.The clinical data of the two groups were compared.Multivariate Logistic regression analysis was used to analyze the influencing factors of pregnancy failure in the patients after moderate to severe intrauterine adhesions surgeries.Results:The proportion of severe intrauterine adhesions,the proportion of not returning to normal menstruation,the proportion of body mass index(BMI)≥30 kg/m^(2) and the proportion of postoperative re-adhesion in the failure group were higher than those in the successful group,and the differences were statistically significant(P<0.05).There were no statistically significant differences between the two groups in terms of age,course of disease,surgical time,use of anti-adhesion devices,surgical method,and frequency of uterine cavity operations(P>0.05).The Logistic regression analysis showed that severe intrauterine adhesions,abnormal menstruation,BMI≥30 kg/m^(2),and postoperative re-adhesions were independent risk factors for the pregnancy failure in the patients after moderate to severe intrauterine adhesions surgeries(OR>1,P<0.05).Conclusions:Severe intrauterine adhesions,abnormal menstruation,BMI≥30 kg/m^(2),and postoperative readhesions are the independent risk factors for the pregnancy failure in the patients after moderate to severe intrauterine adhesions surgeries.