宫腔镜检查在复发性流产患者中的应用  

Application of hysteroscopy in patients with recurrent spontaneous abortion

作　　者：夏松云[1] 王蔼明[1] 商微[1] 李秀琴[1] 

机构地区：[1]中国人民解放军海军总医院妇产科,北京100048

出　　处：《中国妇幼保健》2014年第14期2192-2193,共2页Maternal and Child Health Care of China

基　　金：2011年首都市民健康项目培育项目〔Z111107067311054〕

摘　　要：目的:对有复发性流产史患者子宫内环境改变情况进行研究,以了解复发性流产病史患者宫腔内可能致病的因素。方法:对155例有复发性流产病史患者行宫腔镜检查。子宫纵隔、鞍形子宫、双角子宫、单角子宫和子宫发育不全(幼稚子宫)为先天性子宫异常;宫腔粘连、子宫内膜炎、宫腔息肉和黏膜下肌瘤为获得性子宫异常。结果:发现正常宫腔51例(32.3%),宫内病变例104例(66.6%),其中先天性宫腔病变32例(20.6%),获得性宫腔病变72例(46.4%),在获得性宫腔异常中,宫腔粘连48例(31.0%),子宫内膜炎21例(13.5%),宫腔息肉17例(10.96%),黏膜下肌瘤5例(3.2%)。3次及3次以上复发性流产患者较1次复发性流产患者获得性宫腔异常显著增多(P<0.05)。结论:有复发性流产史患者行宫腔镜检查是必要的,宫腔粘连也是引起复发性流产的一个重要原因。Objective： To research the change of intrauterine environment of patients with recurrent spontaneous abortion （ RSA）, and understand the possible pathogenic factors. Methods： A total of 155 RSA patients underwent hysteroscopy; the types of congenital uter- ine anomalies included uterine septum, saddle - shape uterus, uterus bicornis, unicornuate uterus and uterine hypoplasia; the types of ac- quired uterine abnormalities included intrauterine adhesion, endometritis, uterine polyps and submucous myoma. Results： Among 155 RSA patients, 51 patients （32. 3 % ） were found with normal uteri, and 104 patients （66. 6% ） were found with intrauterine lesions, including 32 patients （20. 6% ） with congenital uterine anomalies and 72 patients （46. 4% ） with acquired uterine abnormalities; among the patients with acquired uterine abnormalities, there were 48 patients （31.0%） with intrauterine adhesion, 21 patients （ 13.5% ） with endometritis, 17 pa- tients （ 10. 96% ） with uterine polyps and 5 patients （3.2%） with submucous myoma. The incidence rate of acquired uterine abnormalities in patients with RSA for three times or more than three times was statistically significantly higher than that in patients with RSA for only one time （P 〈 0. 05） . Conclusion ： Hysteroscopy is necessary for patients with RSA, intrauterine adhesion is one important reason of RSA.

关 键 词：宫腔镜 复发性流产 宫腔粘连子宫畸形 

分 类 号：R714.21[医药卫生—妇产科学]