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在转诊临床环境中,宫腔镜检查对不孕女性的诊断效果和治疗结果:尼日利亚哈科特港的经验。

Diagnostic yield and therapeutic outcome of hysteroscopy in women with infertility in a referral clinical setting: a Port Harcourt, Nigeria experience.

机构信息

Oak Endoscopy Centre, Port Harcourt, Rivers State, Nigeria.

Department of Surgery, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria.

出版信息

Pan Afr Med J. 2021 Feb 11;38:155. doi: 10.11604/pamj.2021.38.155.27101. eCollection 2021.

Abstract

INTRODUCTION

intrauterine pathologies were traditionally evaluated by blind dilatation and curettage along with hysterosalpingography. Hysteroscopy is a veritable tool for evaluation of uterine cavity pathologies with an increasing availability in Nigeria. The study aims to report the diagnostic yield and therapeutic outcome of hysteroscopy in women with infertility from a Nigerian metropolis.

METHODS

a retrospective cross-sectional study of consecutive cases of infertile women referred for hysteroscopy to an ambulatory care endoscopy facility in Port Harcourt, Nigeria. The variables collated included age, parity, past gynaecological history, indication, hysteroscopy findings and interventions. Statistical analysis was performed using SPSS version 25.

RESULTS

included in study were 75 patients undergoing a total of 124 hysteroscopic procedures. The age range of patients was 25 to 56 years (mean 40.7 ± 5.9 years). A positive diagnostic yield of 93.3% with non-visualization of intracavitary uterine pathology in 5 patients was recorded. The most common pathologies were submucous myoma-25(31.3%), endometrial polyps- 18(22.5%) and intrauterine adhesions-18(22.5%). There was no statistical difference between the mean age of patients with or without polyp, myoma and intrauterine adhesions (P = 0.185, P = 0.510 and P = 0.619 respectively) but a non-linear relationship between age and polyp detection (Eta2 = 0.024). Operative hysteroscopies were all performed on out- patient basis but staged in 30(40.0%) patients.

CONCLUSION

benign uterine growths and intrauterine adhesions are frequent causes of uterine factor infertility. A high successful completion rate of hysteroscopic interventions was achieved.

摘要

介绍

传统上,通过盲式扩张和刮宫术联合子宫输卵管造影术来评估宫腔内病变。宫腔镜检查是评估宫腔内病变的有效工具,在尼日利亚越来越普及。本研究旨在报告尼日利亚一个大都市中宫腔镜检查对不孕女性的诊断效果和治疗结果。

方法

这是一项回顾性的连续病例研究,纳入了转诊到尼日利亚哈科特港门诊内镜设施进行宫腔镜检查的不孕女性。收集的变量包括年龄、产次、既往妇科病史、适应证、宫腔镜检查结果和干预措施。使用 SPSS 版本 25 进行统计分析。

结果

研究共纳入 75 例患者,共进行了 124 例宫腔镜检查。患者年龄为 25 至 56 岁(平均年龄 40.7 ± 5.9 岁)。记录到阳性诊断率为 93.3%,5 例患者宫腔内未见病变。最常见的病变是黏膜下肌瘤-25 例(31.3%)、子宫内膜息肉-18 例(22.5%)和宫腔粘连-18 例(22.5%)。有息肉、肌瘤和宫腔粘连的患者的平均年龄之间无统计学差异(P = 0.185、P = 0.510 和 P = 0.619),但年龄与息肉检出之间存在非线性关系(Eta2 = 0.024)。所有手术性宫腔镜检查均在门诊进行,但 30 例(40.0%)患者分期进行。

结论

良性子宫生长物和宫腔粘连是子宫因素不孕的常见原因。宫腔镜干预的成功率很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7de3/8077666/114bddc9282b/PAMJ-38-155-g001.jpg

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