在反复种植失败患者中应用宫腔镜检查及宫腔搔刮术的临床意义  

Clinical significance of hysteroscopy and endometrial scratch in patients with recurrent implantation failure

作　　者：刘玮[1] 陈成[1] 向卉芬[1] 曹云霞[1] 

机构地区：[1]安徽医科大学第一附属医院生殖中心,合肥230022

出　　处：《安徽医科大学学报》2017年第8期1240-1243,共4页Acta Universitatis Medicinalis Anhui

基　　金：卫生部公益性行业科研专项(编号:201402004);国家自然科学基金青年基金项目(编号:81501232)

摘　　要：目的探讨宫腔镜检查及宫腔搔刮术在反复种植失败患者中应用的临床意义。方法选择反复种植失败的不孕患者205例,根据是否行宫腔镜检查和宫腔搔刮术分为3组:A组:行宫腔镜检查联合宫腔搔刮术(n=101);B组:单纯行宫腔搔刮术(n=39);C组:未予任何干预措施(n=65)。将A组按照检查情况分为宫腔形态正常组(A1组)和宫腔形态异常组(A2组),分析A组宫腔镜检查情况,并比较4组患者再次移植周期的临床妊娠率、胚胎种植率及不良妊娠率。结果 A组57.4%宫腔形态正常(A1),42.6%显示宫腔内微小病变(A2),包括子宫内膜炎、子宫内膜息肉及增生、宫腔黏连等。A1组、A2组及B组临床妊娠率与胚胎种植率均明显高于C组,差异有统计学意义(P<0.05),但A1、A2及B组间比较无统计学意义。结论宫腔镜能显示子宫腔内微小病变,宫腔镜检查联合宫腔搔刮术和单纯搔刮术均有助于提高反复种植失败患者的临床妊娠率,但前者与后者相比并未提高临床妊娠率。Objective To investigate the clinical significance o f hysteroscopy and endometrial scratch in the pa-tients with recurrent implantat ion fai lure . Methods 205 patients w i th recurrent implantat ion failure were en ro lled. Based on the use of hysteroscopy and endometrial s c ra tch, patients were div ide d in to three groups hysteroscopy combines endometrial scratch （ group A , = 101 ） , endometrial scratch alone （group B , =39） and no specifictreatment（ group C ,= 65 ） . Group A was then div idedinto two groups according to the outcome o f hysteroscopy, including normal uterine cavity （group Al ） and abnormal uterine cavity （ group A 2 ） . The outcome o f hysteroscopy was analyzed, and rates of cl inic pregnancy in next transfer cycle , implantat ion rates and the rates o f abnormal pregnancy were compared among groups. Results In group A , 57. 4 % were normal uterine cavities（ group A l ）, and 42. 6% were observed with small endometrial lesions （ group A 2 ） , includingendometritis, endometrial polyps and intrauterine adhesions. Cl inical pregnancy rates were sig nif ica nt ly high er in group Al , A 2 , and B than that in group C （ P 〈 0. 05 ） . However, there were no signif icant difference between group Al , A 2, and B . Conclusion Small endometrial lesions can be found by hysteroscopy, the treatment using hysteroscopy combines endometrial scratch or endometrial scratch alone can increase clinic pregnancy rates in the patients with recurrent implantat ion failure , but there is no differences between the two groups.

关 键 词：反复种植失败 宫腔镜 宫腔搔刮术 

分 类 号：R711.6[医药卫生—妇产科学]