宫腔镜对育龄妇女不孕 复发性流产患者宫腔病变的诊断价值  

Diagnostic value of uterine cavity lesions in infertility and recurrentabortion of women of childbearing age by hysteroscopy

作　　者：李芳 穆艳萍 张平 LI Fang;MU Yan-ping;ZHANG Ping(Ningxia Hui Autonomous Region Maternal and Child Health Care Hospital,Ningxia Children's Hospital,Yinchuan,Ningxia 750002,China)

机构地区：[1]宁夏回族自治区妇幼保健院宁夏儿童医院,宁夏银川750002

出　　处：《中国妇幼保健》2023年第19期3806-3809,共4页Maternal and Child Health Care of China

基　　金：中国疾病预防控制中心妇幼保健中心科研项目(20200427)。

摘　　要：目的分析宫腔镜对育龄妇女不孕、复发性流产患者诊断治疗的临床价值。方法回顾性分析2018年4月—2020年5月于宁夏回族自治区妇幼保健院行宫腔镜检查的342例不孕症患者和178例复发性流产患者的病历及随访资料。统计其宫腔镜检查结果及术后妊娠情况。结果520例患者宫腔镜检查均顺利进行,其中328例患者(63.08%)宫腔镜检查无异常,192例患者(36.92%)检查存在宫腔病变。原发性不孕、继发性不孕及复发性流产患者宫腔异常相比较,差异有统计学意义(P<0.05)。复发性流产患者宫腔病变发生率显著高于原发性不孕组(P<0.05);原发性不孕组子宫内膜息肉发病率显著高于继发性不孕和复发性流产患者(P<0.05);继发性不孕和复发性流产患者宫腔粘连发病率显著高于原发性不孕组(P<0.05)。术后434例患者随访成功,最长随访时间28个月,最短随访时间15个月。不孕症组共有103例患者受孕,随访妊娠率为37.32%,复发性流产组患者有56例患者受孕,随访妊娠率为35.44%,差异无统计学意义(P>0.05)。比较各组行宫腔镜手术处理的患者与正常宫腔患者的妊娠结局,原发性不孕组宫腔正常与宫腔异常组活产率比较,差异有统计学意义(P<0.05),其他组内比较,差异均无统计学意义(均P>0.05)。结论宫腔镜检查有助于明确育龄妇女不孕、复发性流产的病因,发现宫腔内病变,并给予相应的治疗,改善患者妊娠情况。Objective To analyze the clinical value of hysteroscopy in diagnosis and treatment of infertility and recurrent abortion in women of childbearing age.Methods The medical records and follow-up data of 342 infertile patients and 178 recurrent abortion patients who underwent hysteroscopy in Ningxia Hui Autonomous Region Maternal and Child Health Care Hospital from April 2018 to May 2020 were retrospectively analyzed.The results of hysteroscopy and postoperative pregnancy were analyzed.Results All 520 patients underwent hyste-roscopy smoothly,328 patients(63.08%)had no abnormal hysteroscopy,and 192 patients(36.92%)had uterine lesions.Compared with primary infertility,secondary infertility and recurrent abortion,the difference was statistically significant(P<0.05).The incidence of uter-ine lesions in recurrent abortion patients was significantly higher than that in primary infertility group(P<0.05).The incidence of endome-trial polyp in primary infertility group was significantly higher than that in secondary infertility and recurrent abortion patients(P<0.05).The incidence of intrauterine adhesion in patients with secondary infertility and recurrent abortion was significantly higher than that in patients with primary infertility(P<0.05).The fllow-up of 434 patients was successful,with the longest follow-up time of 28 months and the shortest follow-up time of 15 months.A total of 103 patients in the infertility group were pregnant,and the follow-up pregnancy rate was 37.32%,while 56 patients in the recurrent abortion group were pregnant,and the follow-up pregnancy rate was 35.44%,the difference was not statistically significant(P>0.05).There were statistically significant differences in pregnancy rate and live birth rate between normal u-terine cavity and abnormal uterine cavity in the primary infertility group(P<0.05),but no significant differences in other groups(P>0.05).Conclusion Hysteroscopy is helpful to clarify the causes of infertility and recurrent abortion in women of childbearing age,find in-trauterine lesi

关 键 词：不孕症 复发性流产 宫腔镜 宫腔病变 诊断 

分 类 号：R711.6[医药卫生—妇产科学]