281例复发性流产患者应用宫腔镜及B超评估宫腔因素的价值及预后分析  

Value of hysteroscopy and type B ultrasonography in evaluation of uterine factors in 281 patients with recurrent spontaneous abortion and prognostic analysis

作　　者：李永丽[1] 宋梦玲[1] 李彩艳[1] 徐仙[1] 胡蓉[1] 赵君利[1] 陈琰[1] 马丽丽[1] LI Yong-Li;SONG Meng-Ling;LI Cai-Yan;et al(Center for Reproductive Medicine, General Hospital of Ningxia Medical University, Key Laboratory of Reproduction and Genetics in Ningxia, Key Laboratory of Fertility Preservation and Maintenance, Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia 750004, Chin)

机构地区：[1]宁夏医科大学总医院生殖医学中心宁夏生殖与遗传重点实验室生育力保持教育部重点实验室,宁夏银川750004

出　　处：《中国妇幼保健》2017年第24期6231-6233,共3页Maternal and Child Health Care of China

基　　金：宁夏自然科学基金项目(NZ14141)

摘　　要：目的探讨宫腔镜及B超在复发性流产患者宫腔因素的评价价值。方法选择2012年5月-2015年6月宁夏医科大学总医院生殖医学中心门诊就诊的复发性流产患者281例作为研究对象,实施宫腔镜检查明确导致复发性流产的宫腔因素,并与分泌期所行B超检查对比,评估实施宫腔镜手术和B超诊断的价值。结果经宫腔镜检查确诊导致复发性流产包括正常宫腔135例,子宫内膜息肉26例,宫腔粘连55例,鞍状子宫34例,子宫内膜炎16例,子宫畸形9例,宫腔偏小6例。与B超对比,子宫内膜的厚度在评价各宫腔异常的患者中一致性较好,各组妊娠结局与诊断有显著关系(P<0.05)。结论复发性流产患者实施宫腔镜检查,有助于疾病的确诊及治疗。超声由于其无创伤且可反复操作,在宫腔粘连的诊断中占有优势,可优先选择。即使是正常宫腔患者,仍有可能再次流产。Objective To explore the value of hysteroscopy and type B ultrasonography in evaluation of uterine factors in patients with recurrent spontaneous abortion （RSA）.Methods A total of 281 patients with RSA treated in Outpatient Department of Center for Reproductive Medicine in General Hospital of Ningxia Medical University from May 2012 to June 2015 were selected,then hysteroscopy was performed to confirm the uterine factors inducing RSA,then the results were compared with those of type B ultrasonography during secretory phase,the value of hysteroscopic surgery and type B ultrasonography was evaluated.Results After hysteroscopic examination,the uterine factors of RSA included normal uterus （135 cases）,endometrial polyps （26 cases）,intrauterine adhesion （55 cases）,saddle-shaped uterus （34 cases）,endometritis （16 cases）,uterus malformations （9 cases）,and smaller uterus cavity （6 cases）.Compared with type B ultrasonography,the consistency of endometrial thickness among the patients with uterine cavity abnormalities was good,pregnancy outcomes was significantly correlated with diagnosis （P〈0.05）.Conclusion Hysteroscopic examination contributes to definite diagnosis and treatment of RSA patients.Ultrasonography has advantages in diagnosis of uterine adhesion because of non-invasion and repeated operation,which is the first choice.Abortion can occur in patients with normal uterus.

关 键 词：宫腔镜 宫腔因素 复发性流产 B超 预后 

分 类 号：R714.21[医药卫生—妇产科学]