摘要
目的：评价宫腔镜检查在反复自然流产患者诊治中的应用价值，了解反复自然流产患者宫腔内可能存在的致病因素。方法对就诊并进行宫腔镜检查的反复自然流产患者192例的临床资料进行回顾性分析，按反复自然流产次数分为三组，A 组：2次流产组；B 组：3次流产组；C 组：＞3次流产。分析各组宫腔异常检出率。结果192例反复自然流产患者宫腔异常检出率54．7％，其中宫腔粘连检出率达34．4％；B 组、C 组宫腔异常和宫腔粘连检出率（B 组：宫腔异常检出率67．1％、宫腔粘连检出率45．6％，C 组：宫腔异常检出率77．8％、宫腔粘连检出率50．0％）均高于 A 组（宫腔异常检出率40．0％、宫腔粘连检出率22．1％），差异均有统计学意义（χ2AB ＝12．69，χ2AC ＝8．69；χ2AB ＝10．78，χ2AC ＝5．47，均 P ＜0．05）；B 组与 C 组宫腔异常和宫腔粘连检出率差异无统计学意义（χ2＝0．78、0．12，均 P ＞0．05）。同时发现其他宫腔异常，包括子宫畸形14例（7．3％）、子宫内膜息肉12例（6．3％）、子宫内膜炎9例（4．7％）、宫颈机能不全2例（1．0％）、黏膜下肌瘤1例（0．5％）、妊娠物残留1例（0．5％）。结论宫腔镜检查是一项无创、直观、安全高效的检查方法，应对反复自然流产患者常规进行宫腔镜检查，及时发现宫腔内可能存在的致病因素并给予治疗以改善妊娠结局。
Objective To evaluate the application value of hysteroscopy in the diagnosis and treatment of recurrent spontaneous abortion patients,and to understand the possible pathogenic factors of recurrent spontaneous abortion.Methods A retrospective study was performed to analyze the findings of 192 cases of recurrent spontaneous abortion,who underwent hysteroscopy examination.According to the number of recurrent spontaneous abortion,they were divided into three groups,group A：2 times abortion group;group B：3 times abortion group;group C：〉3 times abortion group.Then,intrauterine adhesions detection rate was analyzed.Results Of the 192 cases of recurrent spontaneous abortion,the detective rate of uterine abnormality was 54.7%,the intrauterine adhesion was 34.4%,and in group B and group C,the uterine abnormalities and intrauterine adhesions detection rates （group B：uterine abnor-malities 67.1%,intrauterine adhesions detection rate 45.6%;group C：uterine abnormalities 77.8%,intrauterine adhesions detection rate 50.0%）were higher than group A （uterine abnormalities 40.0%,intrauterine adhesions detection rate 22.1%）,the differences were significant（χ2AB =12.69,χ2AC =8.69;χ2AB =10.78,χ2AC =5.47,all P 〈0.05）.The uterine abnormalities and intrauterine adhesions detection rate had no significant difference between group B and group C（χ2 =0.78,0.12,all P 〉0.05）.Also found other uterine abnormalities,including uterine malformation 14 cases（7.3%）,12 cases（6.3%）of endometrial polyps,endometritis in 9 cases （4.7%）,cervical insufficiency in 2 cases（1.0%）,submucous myoma in 1 case （0.5%）,pregnancy residues in 1 case（0.5%）.Conclusion Hyste-roscopy is a noninvasive,intuitive,safe and efficient check.Recurrent spontaneous abortion patients should be routinely performed hysteroscopy,timely detection of pathogenic factors may exist in the uterine and give treatment to improve the pregnancy outcome.
作者
李文媛
王志勇
韩玉芬
张晨静
裴晓洁
李丽
彭方敏
Li Wenyuan Wang Zhiyong Han Yufen Zhang Chenjing Pei Xiaojie Li Li Peng Fangmin(Reproductive Medical Center, Puyang Maternity and Children Health Hospital, Puyang, Henan 457000, Chin)
出处
《中国基层医药》
CAS
2016年第24期3749-3752,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
宫腔镜检查
流产
自然
宫腔异常
宫腔粘连
Hysteroscopy
Abortion,spontaneous
Uterine abnormalities
Intrauterine adhesion
