341例复发性流产患者的宫腔镜检查结果分析

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摘要目的：探讨在复发性流产患者中使用宫腔镜检查的特定时机。方法：回顾性收集我院妇科自2009年1月至2014年12月间收治的复发性流产患者341例的临床资料，按照流产次数分为3组：组1：2次流产；组2：3次流产；组3：≥4次流产。均接受宫腔镜检查，分析组间宫腔异常（先天或获得性）的差异性。结果：组1中101例（占62.7%）宫腔正常，42例（占26.1%）先天性异常，18例（占11.2%）获得性异常；组2中分别为，61例（占51.7%），35例（占29.7%），22例（占18.6%）；组3中此3项数据分别为，29例（占46.8%），18例（占29.0%），15例（占24.2%）。3组患者的宫腔镜检查结果差异无统计学意义（P=0.161）。结论：复发性流产患者中，特别是对难以承受再次流产的晚孕、高龄、焦虑的女性，在连续2次流产后，应将宫腔镜检查列为首选干预措施，积极发现并治疗宫腔异常以改善妊娠结局。

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	陈志文
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关键词 ：复发性流产, 宫腔镜, 宫腔病变

Abstract：Objective: To discuss the appropriate time-window for diagnostic hysteroscopy in patients with recurrent miscarriage. Methods: A retrospective study on the clinical and hysteroscopic investigation of 341 cases with recurrent miscarriage was conducted. According to the number of miscarriages (2, 3, and 4 or more consecutive miscarriages), patients were divided into three groups, and all received diagnostic hysteroscopy for uterine anomalies. Congenital (septate uterus/subseptum, arcuate uterus, unicornuate uterus, uterine hypoplasia) and acquired uterine abnormalities (intrauterine adhesions, polyp and submucous myoma) were recorded. The hysteroscopic results were compared between the groups. Results: No anomalies, congenital and acquired abnormalities in group 1, 2 and 3 were: 101 (62.7%), 42 (26.1%), 18 (11.2%); 61 (51.7%), 35 (29.7%), 22 (18.6%); 29 (46.8%), 18 (29%), 15 (24.2%). No signiﬁcant differences were found in the three groups (P=0.161). Conclusion:
Diagnostic hysteroscopy should be carried out after 2 consecutive miscarriages, in order to determine congenital and acquired uterine anomalies, finally improve pregnancy outcome. Especially in those older, anxious population who cannot venture to lose another pregnancy.

Key words： recurrent miscarriage hysteroscopy uterine anomalies

收稿日期: 2014-12-25

基金资助:温州市科技局科研基金资助项目（Y20140102）。

作者简介: 陈志文（1976-），女，浙江温州人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2015/V45/I4/298

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