子宫内膜息肉患者慢性子宫内膜炎发生情况及相关性分析

Occurrence of chronic endometritis of patients with endometrial polyps and its correlation analysis

目的:探究子宫内膜息肉(EPs)患者慢性子宫内膜炎(CE)发生情况及其相关性。方法:回顾性分析2020年7月-2021年10月于本院接受宫腔镜检查的269例患者临床资料,根据宫腔镜探查及病理结果分为EPs和非EPs患者,根据宫腔镜探查及免疫组织化学CD138染色结果分为CE和非CE患者,采用多因素logistics回归分析法筛选发生子宫内膜息肉的影响因素,所有EPs患者均经宫腔镜探查确认息肉后行手术治疗,分析EPs患者宫腔镜探查后的治疗情况及复发情况。结果:269例患者中EPs、CE、EPs合并CE发生率为47.2%(127/269)、42.8%(115/269)、29.4%(79/269);EPs患者中CE发生率为62.2%,高于非EPs患者的25.4%,差异有统计学意义(P<0.05);绝经、子宫腺肌病、宫颈息肉、CE是EPs发病的危险因素(OR=2.111,95%CI 1.154~3.860;OR=2.529,95%CI 1.289~4.964;OR=2.782,95%CI 1.697~4.558;OR=3.184,95%CI 1.606~6.309)。48例单纯EPs(A组)均未应用任何抗生素治疗,42例EPs伴CE患者(B组)术后均应用多西环素治疗2周,37例EPs伴CE患者(C组)未应用任何抗生素治疗。术后随访12个月,C组异常子宫出血率、息肉复发率显著高于A、B两组(P<0.05)。结论:EPs患者中CE发生率高,绝经、子宫腺肌病、宫颈息肉、CE是EPs发病的危险因素,且CE增加了EPs患者术后异常子宫出血及息肉复发风险,应用抗生素治疗有利于降低异常子宫出血及息肉复发风险。

Objective:To explore the occurrence of chronic endometritis(CE)of patients with endometrial polyps(EPs),and to analyze their correlation.Methods:The clinical data of 269patients who underwent hysteroscopy from July 2020to October 2021were analyzed retrospectively.These patients were divided into CE group and non-CE group according to the results of hysteroscopy exploration and immunohistochemical CD138staining.Multivariate logistic regression analysis was used to screen the influencing factors of EPs occurrence.All the patients with EPs underwent surgical treatment of the confirmed polyps by hysteroscopic exploration,and the status of treatment and polyps recurrence of the patients with EPs after hysteroscopic exploration were analyzed.Results:Among 269patients,the incidences of EPs,CE,and EPs complicated with CE were 47.2%(127/269),42.8%(115/269),and 29.4%(79/269),respectively.The incidence of CE of the patients with CE was 62.2%,which was significantly higher than that(25.4%)of the patients without CE(P<0.05).The menopause,adenomyosis,cervical polyps and CE of the patients were the risk factors of their EPs occurrence(OR=2.111,2.529,2.782,3.184,P<0.05).48patients with EPs alone(in group A)were not treated with any antibiotics,42patients with EPs complicated with CE(in group B)were treated with doxycycline for 2weeks after surgery,and 37patients with EPs complicated with CE(in group C)were not given any antibiotics.In 12months of follow-up after surgery,the rates of abnormal uterine bleeding and recurrence of polyps of the patients in group C were significantly higher than those of the patients in group A and those of the patients in group B(P<0.05).Conclusion:The incidence rate of CE of the patients with EPs is high.The menopause,adenomyosis,cervical polyps and CE of the patients are the risk factors of their EPs occurrence.CE of the patients with EPs increases the risk of their postoperative abnormal uterine bleeding and polyp recurrence,and the antibiotic therapy is beneficial to reducing the risk of the abnormal uterine bleeding and polyp recurrence of the patients.