子宫内膜损伤子宫腔结构异常的诊治与生育功能评估  

Diagnosis and treatment of structural abnormalities of uterine cavity with endometrial injury and evaluation of reproductive function

作　　者：李博涵 段华[1] LI Bo-han;DUAN Hua(Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院北京妇幼保健院,北京100006

出　　处：《中国实用妇科与产科杂志》2025年第3期284-289,共6页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家重点研发计划(2018YFC1004803)。

摘　　要：正常子宫腔结构是保障生育的重要前提。先天性或获得性原因造成的子宫腔解剖学异常不仅破坏了子宫的形态结构,也是导致生育功能下降甚至丧失的重要病因。在获得性子宫腔结构异常病因中,各类原因所致的子宫内膜损伤宫腔粘连致子宫腔形态学破坏并由此所造成的月经量减少、闭经、不孕或复发性流产等,临床常见,已经成为影响女性生育功能和月经生理不容忽视的问题。文章聚焦子宫内膜损伤宫腔粘连导致的子宫腔结构异常,基于循证医学证据,结合国内外专家共识,论述子宫内膜损伤对女性生育功能的影响机制、诊断方法、治疗策略以及生育功能评估的相关研究,从多个层面探讨子宫内膜损伤宫腔粘连所引起的子宫腔结构改变及其对生育功能影响的规范化、个体化诊疗路径及其评估方法,以期为临床诊疗提供参考。The normal structure of the uterine cavity is a fundamental prerequisite for fertility.Anatomical abnormalities of the uterine cavity,whether congenital or acquired,not only damage its structure,but also constitute a significant cause of subfertility or even loss of fertility.Among the causes of acquired uterine structure abnormalities,endometrial injury and intrauterine adhesions(IUAs)leading to morphological disruption of the uterine cavity due to various causes—manifested as reduced menstrual flow,amenorrhea,infertility,or recurrent pregnancy loss—are clinically common and have become critical issues that adversely affect menstrual physiology and reproductive function in women.This review focuses on intrauterine structural abnormalities caused by endometrial injury and IUAs,discussing the researches in the mechanism of endometrial injury affecting female reproductive function,the diagnostic methods,treatment strategies and fertility assessment,studying the changes in uterine structure caused by endometrial injury and IUAs and the standardized and individualized diagnosis and treatment approaches of their effects on reproductive function,as well the assessment methods,aiming to provide valuable references for clinical practice.

关 键 词：子宫腔结构异常 子宫内膜损伤宫腔粘连 生育功能 评估 治疗 

分 类 号：R711.74[医药卫生—妇产科学]