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慢性子宫内膜炎与宫腔粘连的加重呈正相关,但应用抗生素对生殖预后的影响有限。

Chronic endometritis positively correlates with the aggravation of intrauterine adhesions but has limited effects on reproductive prognosis with antibiotic application.

机构信息

Reproductive Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Department of Gynecology and Obstetrics, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

Int J Gynaecol Obstet. 2023 Mar;160(3):986-992. doi: 10.1002/ijgo.14434. Epub 2022 Sep 26.

Abstract

OBJECTIVE

To assess the effect of chronic endometritis (CE) diagnosed by CD138 staining on the aggravation of intrauterine adhesions (IUAs), and the reproductive prognosis after transcervical resection of adhesions (TCRA).

METHODS

Sixty-three patients with severe IUAs (group A) and 119 patients with moderate IUAs (group B) were included in this retrospective study. TCRA and endometrial biopsy with CD138 staining were performed. Participants in each group were classified into two subgroups: CE group and NCE group (without CE). Patients were treated with a course of oral antibiotics for 2 weeks after TCRA. Embryo transfer would be performed if patients had embryos after operations.

RESULTS

Increased incidence of CE was found in group A (18/63, 28.57%) compared with group B (18/119, 15.13%) (P = 0.030). No significant differences were found in the comparisons of chemical pregnancy rate, early miscarriage rate, or full-term pregnancy rate between the CE group and NCE group (P > 0.05), in either the subgroup analysis of group A and group B, or the total analysis.

CONCLUSION

CE has a positive correlation with the aggravation of IUAs. CE did not have a negative impact on the reproductive prognosis of patients with moderate or severe IUAs after TCRA followed by antibiotic administration.

摘要

目的

评估 CD138 染色诊断的慢性子宫内膜炎(CE)对宫腔粘连(IUAs)加重的影响,以及经宫颈粘连切除术(TCRA)后生育预后。

方法

本回顾性研究纳入了 63 例重度 IUAs 患者(A 组)和 119 例中度 IUAs 患者(B 组)。所有患者均行 TCRA 术及 CD138 染色子宫内膜活检。每组患者根据是否存在 CE 分为 CE 组和 NCE 组(无 CE)。TCRA 术后所有患者均口服抗生素 2 周。若术后有胚胎,行胚胎移植。

结果

A 组(18/63,28.57%)CE 发生率高于 B 组(18/119,15.13%)(P=0.030)。A 组和 B 组的 CE 组与 NCE 组间化学妊娠率、早期流产率或足月妊娠率差异均无统计学意义(P>0.05),A 组和 B 组亚组分析及总分析结果一致。

结论

CE 与 IUAs 加重呈正相关。CE 并不会对 TCRA 联合抗生素治疗后中、重度 IUAs 患者的生育预后产生负面影响。

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