首页|宫腔镜冷刀日间手术治疗子宫内膜息肉并不孕患者妊娠结局分析

宫腔镜冷刀日间手术治疗子宫内膜息肉并不孕患者妊娠结局分析

Analysis of pregnancy outcomes in patients with endometrial polyps and infertility treated with hysteroscopic cold knife day surgery

扫码查看
目的:探讨宫腔镜冷刀日间手术治疗子宫内膜息肉合并不孕症患者的妊娠结局.方法:回顾分析 2022 年 3 月至2023 年9 月因不孕症合并子宫内膜息肉行宫腔镜冷刀日间手术的160 例患者的临床资料,观察治疗后行体外受精-胚胎移植术助孕的妊娠情况.根据手术方式分为两组,观察组行宫腔镜冷刀手术+体外受精-胚胎移植术(n=81),对照组行宫腔镜电切术+体外受精-胚胎移植术(n=79),比较两组患者年龄、不孕年限、体重指数、基础卵泡刺激素、基础窦卵泡数、抗苗勒氏管激素及临床妊娠率.结果:两组患者年龄、不孕年限、体重指数、基础卵泡刺激素、基础窦卵泡数及抗苗勒氏管激素水平差异无统计学意义(P>0.05);术后两组临床妊娠率差异亦无统计学意义(47.30%vs.45.31%,P=0.817);组内统计发现,抗苗勒氏管激素高反应组与低反应组临床妊娠率均低于正常反应组,差异有统计学意义(P=0.041,P=0.027);观察组手术时间、术后住院时间、术后移植时间间隔短于对照组,术中出血量少于对照组,住院总费用低于对照组,差异有统计学意义(P<0.001).结论:子宫内膜息肉合并不孕患者于体外受精-胚胎移植助孕前行宫腔镜冷刀治疗对内膜创伤小,医疗成本低,可优先选择.抗苗勒氏管激素正常反应者临床妊娠率较高.
Objective:To investigate the pregnancy outcomes of hysteroscopic cold knife day surgery for patients with endome-trial polyps complicated with infertility.Methods:A retrospective analysis was conducted on the clinical data of 160 patients with infer-tility complicated with endometrial polyps who underwent hysteroscopic cold knife day surgery from Mar.2022 to Sep.2023,and preg-nancy outcomes of in vitro fertilization embryo transfer to assist in pregnancy were observed.Patients were divided into two groups according to the operative method.The observation group received hysteroscopic cold knife surgery+in vitro fertilization embryo transfer(81 cases),while the control group received hysteroscopic electrocision+in vitro fertilization embryo transfer(79 cases).The age,infer-tility years,body mass index,basal follicle stimulating hormone,basal antral follicle count,anti-Müllerian hormone,and clinical pregnan-cy rate of the two groups were compared.Results:There was no statistically significant difference between the two groups in terms of age,time of infertility,body mass index,basal follicle stimulating hormone,basal antral follicle count,and anti-Müllerian hormone(P>0.05).There was no statistically significant difference in the clinical pregnancy rate(47.30%vs.45.31%,P=0.817)between the two groups.Within the observation group and the control group,it was found that the clinical pregnancy rate in the high and low response groups to anti-Müllerian hormone was significantly lower than that in the normal response group,and the difference was statisti-cally significant(P=0.041,P=0.027);the observation group showed a significant reduction in surgical time,postoperative hospitaliza-tion time,postoperative transplant time interval,intraoperative blood loss and total hospitalization costs(P<0.000).Conclusions:Cold knife treatment before in vitro fertilization-embryo transfer has minimal endometrial trauma and low medical costs for patients with endo-metrial polyps and infertility,so it is preferred.Normal responders of anti-Müllerian hormone have higher clinical pregnancy rate.

Endometrial polypsInfertility,femaleHysteroscopyDay surgeryPregnancy outcome

张晟宁、韩喆、王冬梅、刘文娟

展开 >

烟台市烟台山医院生殖医学中心,山东 烟台,264001

烟台市莱阳中心医院妇产科

子宫内膜息肉 不育,女(雌)性 宫腔镜检查 日间手术 妊娠结局

烟台市科技创新发展计划

2022YD064

2024

腹腔镜外科杂志
山东大学

腹腔镜外科杂志

CSTPCD
影响因子:0.861
ISSN:1009-6612
年,卷(期):2024.29(2)
  • 35