278例不孕不育患者宫腔镜检查结果分析  

Clinical analysis of hysteroscopy in 159 cases of infertility

作　　者：金丽萍[1] 王蕊[1] 梁竹巍[1] 戴吉茹[1] 李春霞[1] 

机构地区：[1]首都医科大学附属北京天坛医院妇产科,100050

出　　处：《中国妇幼保健》2008年第29期4155-4157,共3页Maternal and Child Health Care of China

摘　　要：目的：探讨宫腔镜检查在不孕不育患者诊断中的应用价值。方法：对我科2005年1月-2007年4月生殖内分泌门诊因不孕不育接受宫腔镜检查的患者278例的相关资料进行回顾性分析。结果：278例不孕不育患者中宫腔镜检查异常的有199例，阳性率71．58％。原发不孕中宫腔形态异常、子宫内膜炎、内膜息肉、腺体分泌不良的发生率分别为9．63％、23．70％、25．19％、17．04％；继发不孕中的发生率分别为8．40％、31．09％、16．81％、11．76％；流产组中的发生率为29．17％、25．00％、16．67％、8．33％。其中原发不孕组子宫内膜息肉的发生率高于继发不孕组，原发不孕组子宫内膜腺体发育不良的发生率高于流产组，差异有统计学意义。其余各组异常发生率差异无统计学意义。相关性分析发现，子宫内膜炎与不孕不育相关性最密切。结论：宫腔镜检查对不孕不育患者应列为常规检查项目，对于内分泌异常、子宫内膜薄的不孕患者应选择着床窗口期进行宫腔镜检查，可以更好观察子宫内膜腺体情况，指导临床治疗；无论原发还是继发不孕不育均应重视子宫内膜炎症问题。Objective： To explore the clinical effects of hysteroscopy on diagnosis and treatment of infertility. Methods： A retrospective study was conducted on 278 eases perfomed hysteroscopy because of infertility from January 2005 to April 2007. Results： In 278 cases, hysteroscopic examinations found intrauterine diseases in 199 cases （ 199/278, 71. 58% ）. The rate of deformity of uterine cavity, endometria polyps, endometritis, poor mid - secretory endometrium in primary infertility group was respectively 9. 63%0, 23. 70%, 25. 19%, 17. 04%. The rate in secondary infertility group was 8. 40%, 31. 09%, 16. 81%, 11. 76%. The rate in recurrent abortion group was 29. 17%, 25. 00%, 16. 67%, 8. 33%. The rate of endometria polyps in primary infertility group was higher than that in secondary infertility group. The poor mid - secretory endometrium in primary infertility group was significantly higher than that of recurrent abortion group （ all P 〈 0. 05 ）. There was no difference among three groups. By the analysis of univariate, endometrisis had an effect on infertility. Conclusion： Hysteroscopy should be recommended in infertility, especially in eases of abnormal endocrine secretion and thin endometrium. They should be examed during embryo implantation for better observation of endometrium secretory. Endometritis should be thought highly not only in primary infertility but also insecondary infertility.

关 键 词：宫腔镜检查 不孕不育 子宫内膜分泌状态 子宫内膜炎 

分 类 号：R711.6[医药卫生—妇产科学]