复发性流产和异常子宫出血患者宫腔镜检查结果分析  

Clinical analysis of Hysteroscopic examination in 198 cases with recurrent spontaneous abortion and 257 cases with abnormal uterine bleeding

作　　者：邢卫杰[1] 于丛一[1] 李予[1] 冯淑英[1] 陈勍[1] 梁玉萍[1] 罗启东[1] 张清学[1] 

机构地区：[1]中山大学附属第二医院妇产科,广东广州510120

出　　处：《中国妇幼保健》2007年第10期1375-1377,共3页Maternal and Child Health Care of China

摘　　要：目的:评价宫腔镜在复发性流产和异常子宫出血中的应用价值。方法:对198例复发性流产患者(A组)以及257例异常子宫出血者(B组)行宫腔镜检查,了解其宫腔情况,对宫腔异常者,在宫腔镜下进行矫治,追踪随访其妊娠结局。结果:A组198例复发性流产患者宫腔镜检查正常宫腔80例(40.40%),异常宫腔118例(59.60%),其中主要病变类型包括子宫纵隔48例,宫腔粘连32例等;B组257例异常子宫出血患者宫腔镜检查正常宫腔62例(24.12%),异常宫腔195例(75.88%),其中主要病变类型包括子宫内膜肥厚49例,子宫内膜炎46例,子宫内膜息肉45例,子宫粘膜下肌瘤22例。两组患者宫腔镜下的宫腔病变类型有显著性差异(P<0.05)。A组病人共随访到104例,其中正常宫腔17例,足月分娩4例(23.53%);异常宫腔87例,行矫正手术后,足月妊娠分娩45例(51.72%),足月分娩率明显提高。结论:宫腔镜是安全、有效、可行的诊断宫腔病变的检查方法,有助于明确复发性流产和异常子宫出血的病因。对宫腔异常的复发性流产患者,在宫腔镜下进行矫治后,可以明显提高足月分娩率。Objective： To evaluate tho worthiness of hysteroscopic examination in the patients of recurrent spontaneous abortion and abnormal uterine bleeding. Methods： Hysteroscopic examination were performed in 198 women with recurrent spontaneous abortion （Group A） and in 257 women with abnormal uterine bleeding （Group B）. Some patients with abnormal uterine cavity received hysteroscopy metroplasty, and were followed up to the reproductive outcome. Results： In Group A, 80 patients had normal uterine cavity （40.40%）, 118 patients had abnormal uterine cavity （ 59.60% ） , in which the main abnormalities were septate uterus （ n = 48 ） and uterine cavity adhesion （ n =32） ; In Group B, 62 patients had normal uterine cavity （24. 12% ） , 195 patients had abnormal uterine cavity （75.88%） , in which the main types were endometrial hyperplasia （ n = 49 ） , endometritis （ n = 46 ） , endometrial polyps （ n = 45 ） , submucous myoma （ n = 22 ） . The distribution of uterine anomalies in the two groups was distinct different （ P 〈 0. 05 ） . In group A, 104 patients were followed up, 4 out of 17 （23.53% ） women with normal uterine cavity deliveried normally; 45 out of 87 （51.72%） women with abnormal uterine cavity deliveried after hysteroscopic operations. The subsequent term delivery rate of the patients with abnormal uterine cavity was significantly im- proved after metroplasty under hysteroscopy. Conclusion： Hysteroscopy is a safe , effective and feasible method to diagnosis the uterine cavity in women with recurrent spontaneous abortion and abnormal uterine bleeding, and is an outstanding tool to identify the factors. The women with recurrent spontaneous abortion can have an improved term delivery rate.

关 键 词：宫腔镜 复发性流产 异常子宫出血 

分 类 号：R714.21[医药卫生—妇产科学]