阴道超声和宫腔镜检查对不孕患者子宫内膜病变的诊断价值  

Diagnostic value of transvaginal sonography and hysteroscopy for endometrium disorders in infertility women

作　　者：郝翠芳[1] 陈子江[1] 张宁[1] 曲庆兰[2] 王雄[2] 

机构地区：[1]山东大学山东省立医院生殖医学中心,济南250021 [2]烟台毓璜顶医院生殖医学中心,264000

出　　处：《中国实用妇科与产科杂志》2005年第12期733-735,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨阴道超声和宫腔镜检查对不孕患者子宫内膜病变的诊断价值。方法分析2001年2月至2004年7月山东省立医院、烟台毓璜顶医院首次体外受精与胚胎移植(IVFET)部分资料。对IVFET前自然周期超声监测内膜回声异常的52例患者,行宫腔镜检查(研究组Ⅰ),与超声检查内膜正常者(对照组Ⅰ,22例)比较。超声检查内膜正常者进入IVF周期后26例出现异常回声(研究组Ⅱ),IVF后宫腔镜检查,与IVF周期未发现内膜异常回声的,IVFET失败的患者(对照组Ⅱ,32例)比较。结果自然周期超声发现的异常内膜,经宫腔镜确诊(研究组Ⅰ)为78.84%,对照组Ⅰ为9.09%,两组比较差异有非常显著性意义(P<0.01)。促超排卵周期超声发现的异常内膜,IVF后宫腔镜确诊(研究组Ⅱ)为11.54%,对照组Ⅱ为12.50%,两组比较差异无显著性意义(P>0.05)。结论自然周期超声和宫腔镜检查是发现内膜病变的重要方法;超排卵周期超声发现的内膜异常,与内膜对激素的超反应有关,宫腔镜对这种内膜病变的诊断价值有待深入研究。Objective To investigate the diagnostic value of transvaginal sonography and hysteroscopy for the endometrium disorders in infertility women. Methods A total of 132 infertility women in Shandong Province Hospital and Yantai Yuhuangding Hospital from February 2001 to July 2004 were enrolled in this study. They all underwent the examination of hysteroscopy and then proved by transvaginal sonography. 52 cases of abnormal endometrial echoes in natural cycles were taken as study group Ⅰ , while the other 22 cases of normal endometrial echoes served as control group Ⅰ ; 26 cases of abnormal endometrial echoes in vitro fertilization and embryo transfer （ⅠVF-ET） cycles were taken as study group Ⅱ , while the other 32 cases of normal endometrial echoes served as control group Ⅱ, Results The coincidence rate was 78.84% in finding the abnormal endometrium changes between transvaginal sonography and hysteroscopy in the study group Ⅰ , and 9. 09% in control group Ⅰ. There was significant difference between the two groups（ P 〈 0. 01 ）. The coincidence rate was 11.54% in the study group Ⅱ , and 12. 50% in the control group Ⅱ. There was no significant difference between the groups （P 〉 0. 05 ）. Conelusions Both transvaginal sonography and hysteroscopy can be served as important methods in natural cycles to monitor the endometrium disorders. Due to the super - reaction of endometrium to hormones in IVF cycles , the value of hysteroscopy in the finding of endomerium disorders should be further investigated.

关 键 词：阴道超声 子宫内膜 不孕症 宫腔镜 

分 类 号：R71[医药卫生—妇产科学]