子宫内膜息肉合并不孕患者宫腔镜术后不同妊娠结局子宫内膜容受情况的差异性分析

目的探讨分析子宫内膜息肉(EPs)合并不孕症患者宫腔镜术后不同妊娠结局子宫内膜容受情况的差异性。方法选取本院2019年8月至2020年10月收治136例行宫腔镜手术EPs合并不孕症患者为研究对象,按照不同妊娠结局分为妊娠组112例和非妊娠组24例,采用三维超声检测两组患者宫腔镜术后的子宫内膜厚度、子宫内膜类型、宫腔容积、子宫内膜的血流动力学参数和子宫动脉血流参数,评估子宫内膜容受情况。结果术后经超声检测,妊娠组子宫内膜厚度(0.98±0.27)mm大于非妊娠组(0.86±0.10)mm(P<0.05);两组子宫内膜分型差异比较无统计学意义(P>0.05);妊娠组血流分支(8.02±1.47)支高于非妊娠组(7.04±1.40)支(P<0.05);两组子宫内膜血流分型差异显著(P<0.05)。妊娠组子宫内膜血流动脉阻力指数(RI)、搏动指数(PI)均高于非妊娠组(P<0.05),收缩峰值血流速度/舒张末期血流速度比值(S/D)无明显差异(P>0.05);子宫动脉血流RI、PI均高于非妊娠组(P<0.05),S/D无明显差异(P>0.05)。结论经宫腔镜手术治疗后,EPs合并不孕患者不同妊娠结局的子宫内膜容受情况存在差异性,子宫内膜血流分型、子宫内膜、动脉阻力指数(RI)、搏动指数(PI)可辅助评估子宫内膜容受性。

Difference analysis of endometrial receptivity with different pregnancy outcomes in patients with endometrial polyps complicated with infertility after hysteroscopy

Objective:To investigate and analyze the difference of endometrial receptivity in patients with endometrial polyps(EPs)complicated with infertility after hysteroscopy.Methods:136 hysteroscopic patients with EPs complicated with infertility admitted to our hospital from August 2019 to October 2020 were selected as the research objects,and were divided into pregnancy group(112 cases)and non-pregnancy group(24 cases)according to different pregnancy outcomes.Three-dimensional ultrasound was used to detect endometrial thickness,endometrial type,uterine cavity volume,hemodynamic parameters of endometrium and uterine artery blood flow parameters after hysteroscopy in 2 groups,and to evaluate endometrial receptivity.Results:The endometrial thickness of the pregnant group was(0.98±0.27)mm higher than that of the non-pregnant group(0.86±0.10)mm(P<0.05).There was no significant difference in endometrial classification between the two groups(P>0.05).The blood flow branches of pregnant group(8.02±1.47)were higher than those of non-pregnant group(7.04±1.40)(P<0.05).There were significant differences in endometrial blood flow types between the two groups(P<0.05).The resistance index(RI)and pulsation index(PI)of endometrial flow in pregnant group were higher than those in non-pregnant group(P<0.05),but the ratio of peak systolic flow velocity to end diastolic flow velocity(S/D)had no significant difference(P>0.05).The uterine artery blood flow RI and PI were higher than those in non-pregnant group(P<0.05),but S/D had no significant difference(P>0.05).Conclusion:After hysteroscopic surgery,endometrial receptivity varies with pregnancy outcomes in patients with infertility complicated with EPs.Endometrial blood flow type,endometrium,artery resistance index(RI),and pulse index(PI)can assist in the evaluation of endometrial receptivity.