宫腔镜在子宫腺肌病合并不孕妇女子宫内膜病变诊断中的价值

发布时间：2018-05-06 14:52

本文选题：子宫腺肌病 + 不孕症　；参考：《中国微创外科杂志》2017年05期

【摘要】：目的探讨宫腔镜在筛查子宫腺肌病合并不孕妇女子宫内膜病变中的价值。方法 2013年1月~2015年12月因子宫腺肌病合并不孕行宫腔镜检查的573例患者为子宫腺肌病组,因输卵管因素不孕行宫腔镜检查的856例患者为对照组。回顾性分析2组临床资料和宫腔镜检查结果。结果子宫腺肌病组宫腔镜检查发现子宫内膜或宫腔异常的占44.7%(256/573,包括子宫内膜息肉141例,慢性子宫内膜炎77例,宫腔粘连38例),对照组为33.6%(288/856,包括子宫内膜息肉135例,慢性子宫内膜炎96例,宫腔粘连57例),2组间差异有统计学意义(χ~2=11.719,P=0.000)。子宫腺肌病组中子宫内膜息肉患者显著多于对照组[24.6%(141/573)vs.15.8%(135/856),χ~2=17.197,P=0.000]。子宫腺肌病组术前超声检查未发现子宫内膜异常者中39.2%(175/446)宫腔镜检查有异常发现,其中子宫内膜息肉20.2%(90/446)。子宫腺肌病组术前曾行子宫内膜活检病理检查未见异常而胚胎移植失败者中26.3%(26/99)宫腔镜检查发现存在子宫内膜病变。结论子宫腺肌病合并不孕妇女需重视子宫内膜的异常,尤其是子宫内膜息肉。宫腔镜直观、准确,并同时可进行治疗。
[Abstract]:Objective to investigate the value of hysteroscopy in screening endometrial lesions in women with adenomyosis complicated with infertility. Methods from January 2013 to December 2015, 573 patients with adenomyosis complicated with infertility underwent hysteroscopy, while 856 patients with infertility due to fallopian tube factors were treated as control group. The clinical data and hysteroscopy results of two groups were analyzed retrospectively. Results in the adenomyosis group, abnormal endometrium or uterine cavity was found by hysteroscopy, including 141 cases of endometrial polyps, 77 cases of chronic endometritis, 38 cases of intrauterine adhesions, and 33.66% of 856 cases of endometrial polyps, including 135 cases of endometrial polyps. There were significant differences in 96 cases of chronic endometritis and 57 cases of intrauterine adhesion between the two groups (蠂 2 11.719 P < 0. 000). The number of patients with endometrial polyps in the adenomyosis group was significantly higher than that in the control group. In the group of adenomyosis, 39.2% (17.5 / 446) of the patients with endometrial abnormalities were found by ultrasonography before operation, and there were abnormal findings in hysteroscopy, in which the endometrial polyp was 20.2R / 446g. In adenomyosis group, there was no abnormal endometrial biopsy before operation, while 26. 3% of the failure of embryo transfer revealed endometrial lesion by hysteroscopy. Conclusion the abnormality of endometrium, especially endometrial polyps, should be paid more attention to in women with adenomyosis complicated with infertility. Hysteroscopy is intuitive, accurate and can be treated at the same time.
【作者单位】：北京大学第三医院生殖医学中心;
【基金】：国家科技支撑计划(2014BAI05B03)
【分类号】：R711.6;R711.71

【相似文献】