产后宫腔内妊娠物残留的诊断和临床处理  

Diagnosis and treatment of postpartum intrauterine retained products of conception

作　　者：张舒沁 陈练 Shuqin Zhang;Lian Chen(National Centers for Healthcare Quality Management in Obstetrics/National Clinical Research Center for Obstetrics and Gynecology/State Key Laboratory of Female Fertility Promotion/Key Laboratory of Assisted Reproduction,Ministry of Education/Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]国家产科专业医疗质量控制中心、国家妇产疾病临床医学研究中心、女性生育力促进全国重点实验室、辅助生殖教育部重点实验室(北京大学)、北京大学第三医院妇产科,北京100191

出　　处：《中华妇幼临床医学杂志（电子版）》2024年第5期493-497,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家重点研发计划项目(2022YFC2704503);国家自然科学基金项目(82101821);北京市科技新星计划项目(Z211100002121045)。

摘　　要：近年随着辅助生殖技术的临床应用,宫腔内操作的增加,临床上子宫损伤后再妊娠患者增加,随之带来的是产后宫腔内妊娠物残留(RPOC)发生率呈逐年增加趋势。产后宫腔内RPOC可能导致晚期产后出血(PPH)、感染等发生,目前对宫腔内RPOC的诊断标准尚未达成共识,适宜的临床处理方案选择和处理时机,均尚无明确推荐标准。笔者拟主要就宫腔内RPOC患者的临床表现及诊断,以及临床处理中适宜临床处理方案选择和处理时机的最新研究现状进行阐述,旨在为产后宫腔内RPOC患者的临床管理和后续研究方向提供参考。In recent years,with the widespread use of assisted reproductive technology and the increase in intrauterine procedures,the number of patients experiencing re-pregnancy after uterine injury has risen,along with a growing incidence of postpartum intrauterine retained products of conception(RPOC).Postpartum RPOC can lead to complications such as late postpartum hemorrhage(PPH)and infections.Currently,there is no consensus on the diagnostic criteria for RPOC,nor are there clear recommendations regarding the selection of appropriate clinical treatment plans or timing.This article aims to review the latest research on the clinical manifestations and diagnosis of RPOC,as well as the most suitable treatment options and timing,to provide guidance for clinical management and future research directions in the follow-up of postpartum RPOC patients.

关 键 词：妊娠物残留 诊断 宫腔镜 产后出血 保守治疗 外科手术 女(雌)性 

分 类 号：R711[医药卫生—妇产科学]