不孕症患者子宫内膜息肉切除后妊娠结局多因素分析

doi:10.3969/j.issn.1006-7795.2025.04.021

摘要/Abstract

摘要：

目的探讨不孕症患者行宫腔镜子宫内膜息肉电切术（transcervical resection of polyp， TCRP）后妊娠结局的影响因素。方法回顾分析2021年3月至2022年3月442例TCRP术的不孕症合并子宫内膜息肉（endometrial polyp，EP）患者资料，术后随访12～24个月，分为术后妊娠组（妊娠组）及未妊娠组（对照组）。比较年龄、体质量指数（body mass index，BMI）、不孕类型、异常子宫出血、不良孕史、EP数量、EP大小、术中负压吸宫术、子宫内膜炎、TCRP术手术时间、宫腔深度，对不孕症患者TCRP术后妊娠结局的影响因素进行多因素分析。结果 442例不孕症合并EP患者中，妊娠组274例（62.0%），对照组168例（38.0%）；影响不孕症行TCRP术后妊娠的因素有年龄（OR=0.925,95% CI:0.881～0.972, P<0.05）、术前异常子宫出血（OR=0.646,95% CI:0.432～0.967, P<0.05）及原发不孕（OR=2.105,95% CI:1.295～3.423, P<0.05）。结论 TCRP术后可以改善不孕症合并EP的妊娠结局，年龄和术前异常子宫出血是不孕症患者TCRP术后提高妊娠的保护因素；原发不孕是不孕症患者TCRP术后妊娠的危险因素。

关键词: 不孕症, 子宫内膜息肉, 宫腔镜子宫内膜息肉电切术, 妊娠结局, 活产率, 相关因素

Abstract: Objective To investigate the influencing factors of pregnancy outcomes after transcervical resection of polyp (TCRP) in infertility patients. Methods The data of 442 patients with infertility complicated with endometrial polyp (EP) underwent TCRP from March 2021 to March 2022 were retrospectively analyzed, and the postoperative follow-up time was 12-24 months, and they were divided into postoperative pregnancy group (pregnancy group) and non-pregnant group (control group). The two groups were compared with age, body mass index (BMI), infertility type, abnormal uterine bleeding, adverse pregnancy history, number of EP, EP size, intraoperative negative pressure uterine aspiration, endometritis, TCRP operation time, and uterine cavity depth, and multivariate analysis was conducted on the influencing factors of pregnancy outcomes after TCRP in infertility patients. Results Among 442 infertility patients with EP, 274 cases (62.0%) were in the pregnancy group and 168 cases (38%) in the control group. The factors

influencing pregnancy after TCRP were age (OR=0.925, 95%CI:0.881-0.972, P<0.05), abnormal uterine bleeding before surgery (OR=0.646, 95%CI: 0.432-0.967, P<0.05) and primary infertility (OR=2.105, 95%CI:1.295-3.423, P<0.05). Conclusion TCRP can improve pregnancy outcomes in infertility patients with EP. Age and abnormal uterine bleeding before operation were the protective factors to increase pregnancy after TCRP in infertility patients. Primary infertility is a risk factor for pregnancy after TCRP in infertility patients.

Key words: infertility, endometrial polyp, transcervical resection of polyp, pregnancy outcomes, live birth rate, related factors

中图分类号:

R714

郭艳, 夏恩兰, 肖豫, 黄晓武. 不孕症患者子宫内膜息肉切除后妊娠结局多因素分析[J]. 首都医科大学学报, 2025, 46(4): 724-728.

Guo Yan, Xia Enlan, Xiao Yu, Huang Xiaowu. Multivariate analysis of pregnancy outcomes after transcervical resection of polyp in infertility patients[J]. Journal of Capital Medical University, 2025, 46(4): 724-728.

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