| Objective:To research the clinical date of 242 cases of intrauterine adhesions which was diagnosed and treatment by hysteroscopy, to analyze the related factors, the clinical features, influence factors of intrauterine adhesions degree, process mode and the recovery of postoperative, to provide a reference for the diagnose, prevention, prognosis and treatment of intrauterine adhesions.Methods:Collecte the clinical date of 242 cases of intrauterine adhesions which was diagnosed and treatment by hysteroscopy of Second Affiliated Hospital of Chongqing Medical University in 2012 October to 2014 August, follow-up postoperative related situation, analyze their age, artificial abortion and curettage, clinical symptoms, operation, menstrual improvement and pregnancy.Results:1. Age:The maximum age of 47 years, the minimum age of 19 years, include 15-25 years old of age in 27 cases (11.20%),26-35 years of age in 157 cases (64.90%),36-45 years of age in 56 cases (23.10%),46-55 years of age in 2 cases (0.80%).2. Abortion and curettage:In 242 cases of IUA patients,235 cases had abortion history,7 cases had no abortion history. Abortion times is to 1-10 times. The abortion of 1 times has 42 cases (42/235),2 times has 51 cases (51/235),3 times has 58 cases (58/235),4 times has 38 cases (38/235),5 times has 22 cases(22/235),24 cases times has more than 6 times (24/235).3. Symptom:In the article, there are 236 cases(97.52%) of patients have symptoms inside the 242 cases, while the other 6 patients (2.48%) came to hospital with asymptomatic. In the 236 cases of patients, there are 32 cases (32/236) for secondary infertility,1 cases of periodic abdominal pain (1/236),203 cases of menstrual disorder (203/236). In the patients of menstrual disorder,143 cases (143/203) are oligomenorrhea, 58 cases (58/203) are menopauseor even amenorrhea. The main symptoms is oligomenorrhea (59.09%), in which young women (aged less than 35 years old) have 119 cases (83.22%), while older women (age> 35 years old) have 24 cases (16.78%).Upon examination P< 0.05, there was significant.4. The degree of IUA:In this paper, grade ? has 42 cases, ? in 55 cases, grade ? in 96 cases, grade ? in 33 cases, V in 16 cases.? The degree of IUA were correlated with the age showed:Count the constituent ratio of diferrent IUA between the young and the old, which showed no significant correlation between the degree of IUA and the age of patients (P>0.05).? The adhesion degree associated with abortion history showed: Count the constituent ratio of diferrent IUA of diferrent abortion times, it showed no significant correlation between the degree of IUA and the abortion times (P>0.05).?The IUA degree associated with menstrual disorder showed:IUA in I with the symptom of oligomenorrhea and amenorrhea accounted for 77.78%,22.22%, ? accounted for 74.47%,25.53%, ? accounted for 69.04%,30.96%, ? accounted for 66.67%,33.33%,? accounted for 60%,40%, Above all, examination P<0.05, there was significant.?IUA was related to the duration of clinical symptoms which showed: 203 cases have menstrual disorder,73 cases (73/203) get the duration of more than 1 years, while 130 cases(130/203) is less than or equal to 1 years. Count the constituent ratio of diferrent IUA of the diferrent duration, it showed no significant correlation between the degree of IUA and the duration of clinical symptoms (P>0.05).5. Menstruation:There are 132 cases (70.59%) has improved for menstruation after treatment.? 17 patients of 132 cases of older women get menstrual improvement (12.88%), while young women have 115 cases (87.12%). Upon examination P< 0.05, there was significant.?the long duration(over 1 year) have 38 cases (58.46%) for menstrual improvement, while less than 1 years after treatment get 115 cases of menstrual improvement (77.05%). Upon examination P< 0.05, there was significant.(3)In 203 cases of IUA patients with menstrual disturbances, after treatment by hysteroscopy, the IUA I-V degrees for menstruation improved accounted for 17.42%,25.76%,48.48%,5.30%,3.04%. Upon examination P< 0.05, there was significant. The I-III of patients with menstrual improvement was better than IV-V, and P< 0.05, there was significant.? Menstruation is not obviously related with operation mode(P> 0.05).6. Pregnancy:There are 78 cases have fertility requirements at present in all patients,only 52 cases get a successful pregnancy. The total pregnancy rate gets 66.66%,among them,the level I has 18 cases, the level II has 14 cases, the level in has 19 cases, IV for 1,nothing in level V. Upon examination P< 0.05, there was significant.Conclusion:1. In this paper,242 cases of IUA with age gets from 26-35 years old,which is the peak stage of growth period. Operation is one of the causes of intrauterine adhesions, abortion is one of the high risk factors in the pathogenesis of intrauterine adhesions. Therefore, for all sexually active women, especially in the age groupof 26-35 years old, we should appeal it that it should pay attention for good contraception for abortion.2. the main symptom of IUA is oligomenorrhea. Young women have a higher degree of awareness and treatment for the reduction tendency. Clinical symptoms reflect the severity of intrauterine adhesions in a certain extent, the degree of adhesion is lighter, the menstrual disorder is also lighter.3. There are no significant communication with the duration, abortion,age and the degree of IUA. Any time the operation may cause severe adhesion.4.Age, the duration of disease, the degree of IUA has certain influence on menstrual improvement after trement. The efficiency of the treatment is better with the youth or the shorte duration or the the lighter intrauterine adhesions. The degree has a certain effect on the postoperative pregnancy. Therefore, the detection time more early, the treatment effect is better. |
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