118例宫腔粘连患者的临床指标分析

目的 探讨重度与非重度宫腔粘连（IUA）患者各项临床指标之间的差异。方法 收集经宫腔镜确诊IUA的118例患者的临床资料，根据IUA AFS评分标准将患者分为重度IUA组（重度组，41例）和轻中度IUA组（非重度组，77例），并分析2组患者各项临床指标间的差异。结果 与非重度组患者比较，重度组患者的孕次较多、2次以上清宫史者比例较高、宫腔镜电切操作次数较多（P均< 0.05）。2组中人工流产术后、宫腔镜下电切术后、子宫动脉栓塞术联合清宫术后宫腔操作史者比例比较差异均有统计学意义（P均< 0.05）。重度组患者中宫腔操作次数 ≥3次者比例（85%）高于非重度组（P < 0.05）;重度组患者中经阴道彩色多普勒超声提示宫腔异常（回声不均、连续性中断、显示不清或粘连）者的比例高于非重度组（P < 0.05）。结论 人工流产术、宫腔镜下电切术和子宫动脉栓塞后清宫术可增加IUA发生的风险，经阴道彩色多普勒超声对重度IUA有较好的诊断价值。

Analysis of clinical indicators in 118 patients with intrauterine adhesions

Objective To explore the differences of different clinical indicators between patients with severe and non-severe intrauterine adhesions （IUA）. Methods Clinical data of 118 patients with IUA diagnosed by hysteroscopy were analyzed retrospectively. According to the AFS scoring standard of IUA, all patients were divided into the severe IUA group （severe group） and mild-moderate IUA group （non-severe group）, and the differences of different clinical indicators between two groups were analyzed. Results Compared with the patients in the non-severe group, the patients in the severe group had more pregnancies, more than two times of uterine curettage, and more times of hysteroscopic resection （all P < 0.05）. There were statistically significant differences between the severe and non-severe groups after induced abortion, hysteroscopic resection, and uterine artery embolization combined with curettage （all P < 0.05）. Among the patients undergoing different times of uterine cavity operations, the difference between the severe and non-severe groups was statistically significant. Compared with the 1-time and 2-time uterine cavity operation groups, the proportion of severe group （85%） in the ≥3-time uterine cavity operation was significantly increased （both P < 0.05）. In the severe group, the proportion of abnormal uterine cavity （heterogenous echoes, continuous interruption, unclear display or adhesion） revealed by transvaginal color Doppler ultrasound was significantly higher than that in the non-severe group （P < 0.05）. Conclusions Induced abortion, hysteroscopic electrosurgery and uterine curettage after uterine artery embolization can increase the risk of IUA. Transvaginal color Doppler ultrasound has good diagnostic value for severe IUA.