摘要
目的探究超声联合宫腔镜治疗黏膜下子宫肌瘤的疗效及影响术后妊娠的因素。方法回顾性分析2017年10月—2018年10月就诊于该院的黏膜下子宫肌瘤患者101例,根据手术方式将其分为观察组51例和对照组50例,对照组采取开腹手术治疗,观察组采取超声联合宫腔镜治疗,随访12~18个月。观察并比较观察组和对照组手术指标、术后并发症发生情况、子宫肌瘤复发率和妊娠率;并用单因素和Logistic多因素分析影响观察组患者术后妊娠的因素。结果观察组患者的手术时间、肛门排气时间、术中出血量、住院时间、下床活动时间均显著低于对照组,差异均有统计学意义(均P<0.05);观察组术后并发症的发生率(21.57%)显著低于对照组(56.00%),差异有统计学意义(P<0.05);观察组子宫肌瘤复发率(3.92%)显著低于对照组(32.00%),妊娠率(68.63%)显著高于对照组(22.00%),差异均有统计学意义(均P<0.05);经单因素和Logistic多因素分析发现,年龄>35岁、体质量指数(body mass index,BMI)>25kg/m2、侵入性操作、宫腔压力、未使用凝胶是造成观察组患者术后不易妊娠的独立危险因素(P<0.05)。结论超声联合宫腔镜治疗黏膜下子宫肌瘤的疗效显著,且年龄、BMI、侵入性操作、宫腔压力、凝胶使用情况会影响患者的术后妊娠。
Objective To explore the effect of ultrasound combined with hysteroscopy in the treatment of submucousmyoma and the factors influencing pregnancy.Methods One hundred and one patients with submucousmyoma were selected from October 2017 to October 2018.According to the operation method,they were divided into 51 cases in the observation group and 50 cases in the control group.The control group was treated by laparotomy,observation group was treated by ultrasound combined with hysteroscopy and followed up for 12-18 months.Observe and compare the operation indexes,postoperative complications,recurrence rate of uterine fibroids and pregnancy rate of the observation group and the control group,and analyze the factors influencing the postoperative pregnancy of the observation group with single factor and logistic multiple factors.Results The operation time,anal exhaust time,intraoperative blood loss,hospitalization time and activity time of patients in the observation group were significantly lower than those in the control group(P<0.05).The incidence of postoperative complications in the observation group(21.57%)was significantly lower than thatin the control group(56.00%),and the difference was statistically significant(P<0.05).The recurrence rate of hysteromyoma in the observation group(3.92%)was significantly lower than that in the control group(32.00%),and the pregnancy rate(68.63%)was significantly higher than that in the control group(22.00%).Through univariate and Logistic multivariate analysis,it was found that age>35 years old,body mass index(BMI)≤25 kg/m^2,invasive operation,uterine cavity pressure,and non-use of gel were the factors that affected the observation group after surgery Independent risk factors for difficult pregnancy(P<0.05).Conclusion Ultrasound combined with hysteroscopy is effective in the treatment of submucousmyoma.But age,BMI,invasive operation,intrauterine pressure and gel usage will affect postoperative pregnancy.
作者
范刚
龚懂文
张梅
Fan Gang;Gong Dongwen;Zhang Mei(Bazhong Central Hospital,Bazhong 636600 tChina)
出处
《中国煤炭工业医学杂志》
2020年第5期500-505,共6页
Chinese Journal of Coal Industry Medicine
基金
四川省卫生厅科研项目(编号:20170446)。
关键词
超声
宫腔镜
黏膜下子宫肌瘤
术后妊娠
Ultrasound
Hysteroscopy
Submucousmyoma
Postoperative pregnancy
