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人工流产患者宫腔粘连危险因素评估及宫腔镜手术疗效观察

Assessment of Risk Factors of Intrauterine Adhesions in Patients With Induced Abortion and the Curative Effect of Hysteroscopic Surgery.

作者信息

Mo Xiaoliang, Qin Guirong, Zhou Zhoulin, Jiang Xiaoli

机构信息

a Department of Gynecology and Obstetrics , The First Affiliated Hospital of Guangxi Medical University , Nanning , 530021 , Guangxi , PR China.

出版信息

J Invest Surg. 2019 Jan;32(1):85-89. doi: 10.1080/08941939.2017.1376130. Epub 2017 Oct 3.

Abstract

OBJECTIVE

To explore the risk factors for intrauterine adhesions in patients with artificial abortion and clinical efficacy of hysteroscopic dissection.

METHODS

1500 patients undergoing artificial abortion between January 2014 and June 2015 were enrolled into this study. The patients were divided into two groups with or without intrauterine adhesions. Univariate and Multiple logistic regression were conducted to assess the effects of multiple factors on the development of intrauterine adhesions following induced abortion.

RESULTS

The incidence rate for intrauterine adhesions following induced abortion is 17.0%. Univariate showed that preoperative inflammation, multiple pregnancies and suction evacuation time are the influence risk factors of intrauterine adhesions. Multiple logistic regression demonstrates that multiple pregnancies, high intrauterine negative pressure, and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortion. Additionally, intrauterine adhesions were observed in 105 mild, 80 moderate, and 70 severe cases. The cure rates for these three categories of intrauterine adhesions by hysteroscopic surgery were 100.0%, 93.8%, and 85.7%, respectively.

CONCLUSION

Multiple pregnancies, high negative pressure suction evacuation and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortions. Hysteroscopic surgery substantially improves the clinical outcomes of intrauterine adhesions.

摘要

目的

探讨人工流产患者发生宫腔粘连的危险因素及宫腔镜下粘连分离术的临床疗效。

方法

选取2014年1月至2015年6月期间行人工流产术的1500例患者纳入本研究。将患者分为有或无宫腔粘连两组。采用单因素和多因素logistic回归分析评估多种因素对人工流产后宫腔粘连发生的影响。

结果

人工流产后宫腔粘连的发生率为17.0%。单因素分析显示术前炎症、多次妊娠及吸宫时间是宫腔粘连的影响危险因素。多因素logistic回归分析表明,多次妊娠、宫腔高负压及吸宫时间长是人工流产后宫腔粘连发生的独立危险因素。此外,观察到轻度宫腔粘连105例、中度80例、重度70例。宫腔镜手术对这三类宫腔粘连的治愈率分别为100.0%、93.8%和85.7%。

结论

多次妊娠、高负压吸宫及吸宫时间长是人工流产后宫腔粘连发生的独立危险因素。宫腔镜手术可显著改善宫腔粘连的临床结局。

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