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目的探讨影响宫腔粘连分离术患者预后不良的危险因素。方法选择无锡市妇幼保健院2013年1月-2014年12月收治的宫腔粘连患者210例作为研究对象,随访观察患者术后1年的疗效,并对影响患者不良预后的相关因素行单因素和多因素Logistic回归分析。结果 210例患者不良预后47例,不良预后率为22.4%;单因素分析显示,重度宫腔粘连、病程>12个月、能源性分离、致密性宫腔粘连、术前闭经、人工流产>3次、宫腔粘连范围>2/3、宫腔粘连部位为双侧宫角封闭、术前宫腔操作次数≥2次、未实施人工周期和内置节育器治疗等因素与不良预后关系密切,差异均有统计学意义(均P<0.05);多因素回归分析显示,致密性宫腔粘连、病程>12个月、人工流产次数>3次、术前宫腔操作次数≥2次、宫腔粘连部位为双侧宫角封闭等因素为不良预后的强危险性因素(P<0.05)。结论病程、术前操作及人工流产次数、宫腔粘连性质和粘连部位等均是影响宫腔粘连分离术预后不良的独立危险因素,因此临床应加强对上述因素的控制和预防,给予宫腔粘连患者早期治疗,以改善患者预后。
Objective To investigate the risk factors for poor prognosis in patients with intrauterine adhesions. Methods A total of 210 patients with intrauterine adhesions treated in Wuxi Maternal and Child Health Hospital from January 2013 to December 2014 were selected as the research objects. The patients were followed up for 1 year after operation. The related factors affecting the patients’ And multivariate logistic regression analysis. Results The adverse prognosis of 210 patients was 47 and the rate of adverse prognosis was 22.4%. Univariate analysis showed that severe intrauterine adhesions with duration of> 12 months had energy separation, dense intrauterine adhesions, preoperative amenorrhea and induced abortion> 3 Second, intrauterine adhesions range> 2/3, uterine cavity adhesions bilateral horn closed, preoperative uterine cavity operation times ≥ 2 times, no artificial cycle and IUD treatment and other factors are closely related to poor prognosis, the difference (All P <0.05) .Multivariate regression analysis showed that the density of intrauterine adhesions, duration of> 12 months, the number of induced abortion> 3 times, the number of preoperative uterine cavity operation ≥ 2 times, intrauterine adhesions Location of the bilateral uterine horn closure and other factors as a strong risk factor for poor prognosis (P <0.05). Conclusions The course of disease, the number of preoperative operation, the number of induced abortion, the adhesion properties of the uterine cavity and the adhesion sites are all the independent risk factors for the poor prognosis of intrauterine adhesions. Therefore, we should strengthen the control and prevention of the above factors and give intrauterine adhesions Early treatment of patients to improve patient prognosis.