张琳　刘芳

[摘要] 目的 分析宫腔镜子宫内膜息肉合并不孕患者行TCRP术后的妊娠结局及影响因素。 方法 选择2014年1～12月在我院接受治疗的子宫内膜息肉合并不孕者75例，均在院内接受宫腔镜子宫内膜息肉电切（TCRP）术，术后随访12～24个月，分析妊娠结局及影响因素。 结果 术后12个月内自然妊娠者15例，其中正常分娩者10例（66.67%），流产1例（6.67%），早产4例（26.67%）；术后24个月内自然妊娠者33例，其中正常分娩者26例（78.79%），流产2例（6.06%），早产5例（15.15%）；术后24个月自然妊娠率及正常分娩率均高于术后12个月（P均<0.01）；患者年龄、子宫息肉直径、个数、部位、糖尿病、不孕类型以及BMI值与术后妊娠情况存在一定的关系。 结论 采取宫腔镜子宫内膜息肉电切术（TCRP）可获得良好的临床效果，而且年龄、子宫息肉直径、个数、部位、糖尿病、不孕类型以及BMI值与术后妊娠率之间存在一定的关联。

[关键词] 宫腔镜；子宫内膜息肉；不孕；TCRP术；妊娠结局

[中图分类号] R737.3 [文献标识码] B [文章编号] 1673-9701（2018）10-0064-03

Analysis of pregnancy outcomes and influencing factors after TCRP in patients who had endometrial polyps combined with infertility

ZHANG Lin LIU Fang

Department of Obstetrics and Gynecology， Tianyou Hospital Affiliated to Wuhan University of Science and Technology， Wuhan 430064， China

[Abstract] Objective To analyze the pregnancy outcomes and influencing factors after TCRP in patients who had endometrial polyps combined with infertility. Methods 75 patients who had endometrial polyps combined with infertility and were treated in our hospital from January 2014 to December 2014 were enrolled in this study. Trans cervical resection of endometrial polyps（TCRP） was performed to all participants （TCRP） under hysteroscope. They were followed up for 12-24 months and the pregnancy outcomes and influencing factors were analyzed. Results There were 15 cases of spontaneous pregnancy within 12 months after operation， including 10 cases of normal delivery（66.67%）， 1 case of abortion（6.67%） and 4 cases of premature delivery（26.67%）. There were 33 cases of spontaneous pregnancy within 24 months after operation， including 26 cases of normal delivery（78.79%）， 2 cases of abortion （6.06%） and 5 cases of premature

delivery （15.15%）. The rates of natural pregnancy and normal delivery at 24 months after operation were significantly higher than those at 12 months after operation（all P<0.01）. Age， diameter， number and location of uterine polyps，diabetes，type of infertility，BMI were associated with postoperative pregnancy. Conclusion TCRP had good clinical effect， and age， uterine polyp diameter， number，location，diabetes，type of infertility， and BMI were related to postoperative pregnancy rate.

[Key words] Hysteroscope； Endometrial polyps； Infertility； TCRP； Pregnancy outcomes

子宮内膜息肉属于一种妇科常见良性疾病，主要临床特征包括月经量过多、周期异常、不规则阴道流血等，是女性不孕的重要原因之一。子宫内膜息肉多经B超、宫腔镜检查及术后病理等诊断[1-2]。随着现代医疗技术的不断发展，子宫内膜息肉检出率目前逐年上升。本次研究选择2014年1～12月在我院接受治疗的子宫内膜息肉合并不孕者75例，分析其妊娠结局及影响因素，获得一定研究成果，现报道如下。

1 资料与方法

1.1 一般资料

本次研究选择2014年1～12月在我院接受治疗的子宫内膜息肉合并不孕者75例，年龄20～35岁，平均（30.50±3.67）岁；均为已婚者，未避孕，正常性生活。不孕病史1～6.5年，平均（2.85±0.65）年；原发性不孕26例，继发不孕49例，既往有流产史者12例，非月经阴道不规则出血者15例；子宫内膜息肉单发61例，多发14例。

1.2 纳入标准

（1）临床资料完整，年龄20～35岁之间；已经确诊子宫内膜息肉合并不孕诊断。……