宫腔镜在人工流产术后宫腔粘连诊治中的应用  

Application of Hysteroscopy in Diagnosis and Treatment of Intrauterine Adhesion after Induced Abortion

作　　者：裴利花[1] 李艳青[1] PEI Lihua;LI Yanqing(Changzhi Medical College Affiliated Heping Hospital,Changzhi,Shanxi 046000,China)

机构地区：[1]长治医学院附属和平医院

出　　处：《大医生》2019年第3期36-37,47,共3页Doctor

摘　　要：目的 探讨人工流产术后宫腔粘连(IUA)应用宫腔镜进行诊治的价值。方法 选取2016年1月至2018年1月长治医学院附属和平医院收治的61例人工流产术后宫腔粘连患者,统计宫腔镜诊治情况(粘连诊断情况、手术用时、出血量、并发症发生情况)、术后3个月宫腔形态恢复情况、月经恢复情况、周期性腹痛患者腹痛缓解情况、排卵期子宫内膜厚度。随访1年,统计不孕患者妊娠情况。结果 61例人工流产术后宫腔粘连患者,膜状疏松粘连55例,致密粘连6例,均行电镜下分离粘连或电切除粘连带手术,手术用时15~46 min,平均(32.49±6.76)min;出血量10~45 mL,平均(21.16±5.58)mL;无子宫穿孔、水中毒、大出血等并发症发生。宫腔形态均恢复正常(100.00%),58例(95.08%)患者术后1~3个月月经恢复正常。9例周期性下腹痛患者中,术后腹痛消失7例(77.78%),腹痛不同程度缓解2例(22.22%)。7例不孕患者中,术后1年成功妊娠3例(42.86%)。结论 宫腔镜集检查、诊断、手术治疗为一体,诊治IUA准确有效,且安全可靠,应用价值较高。Objective To investigate the application value of hysteroscopy in the diagnosis and treatment of intrauterine adhesion(IUA)after induced abortion.Methods Sixty-one patients with IUA after induced abortion admitted to Changzhi Medical College Affiliated Heping Hospital from January 2016 to January 2018 were collected.The diagnosis and treatment of patients by hysteroscopy were analyzed,including diagnosed adhesion situation,operation time,bleeding volume and complications.Moreover,after 3 months,the recovery of uterine cavity morphosis and menstruation,pain relief of patients with periodic abdominal pain,and endometrial thickness during ovulation,as well as pregnancy of patients with infertility during 1-year follow up were analyzed.Results Among the 61 patients with IUA after induced abortion,55 cases had membranous loose adhesion and 6 had dense adhesion.All patients were performed separation of adhesion or electrical resection of the adhesive tape under electron microscope,and the operation time was 15~46 min,mean(32.49±6.76)min;bleeding volume of 10~45 mL,mean(21.16±5.58)mL,with no complication such as uterine perforation,water poisoning or major bleeding.Uterine cavity morphology in all patients returned to normal(100.00%),menstruation recovered in 58 cases(95.08%)during 1~3 months after operation.Among 9 patients with periodic abdominal pain,abdominal pain disappeared in 7 patients(77.78%),and relieved in 2 patients(22.22%).There were 3 cases(42.86%)with successful pregnancy 1 year after operation among 7 infertility patients.Conclusion The function of hysteroscopy is a combination of examination,diagnosis and surgical treatment.The diagnosis and treatment of IUA by hysteroscopy is accurate,effective,safe and reliable,with high application value.

关 键 词：人工流产 周期性腹痛 子宫穿孔 宫腔形态 子宫内膜厚度 妊娠情况 宫腔镜 粘连带 

分 类 号：R71[医药卫生—妇产科学]