在反复种植失败患者中应用宫腔镜检查及宫腔搔刮术的临床意义

发布时间：2018-05-21 02:40

本文选题：反复种植失败 + 宫腔镜　；参考：《安徽医科大学学报》2017年08期

【摘要】：目的探讨宫腔镜检查及宫腔搔刮术在反复种植失败患者中应用的临床意义。方法选择反复种植失败的不孕患者205例,根据是否行宫腔镜检查和宫腔搔刮术分为3组:A组:行宫腔镜检查联合宫腔搔刮术(n=101);B组:单纯行宫腔搔刮术(n=39);C组:未予任何干预措施(n=65)。将A组按照检查情况分为宫腔形态正常组(A1组)和宫腔形态异常组(A2组),分析A组宫腔镜检查情况,并比较4组患者再次移植周期的临床妊娠率、胚胎种植率及不良妊娠率。结果 A组57.4%宫腔形态正常(A1),42.6%显示宫腔内微小病变(A2),包括子宫内膜炎、子宫内膜息肉及增生、宫腔黏连等。A1组、A2组及B组临床妊娠率与胚胎种植率均明显高于C组,差异有统计学意义(P0.05),但A1、A2及B组间比较无统计学意义。结论宫腔镜能显示子宫腔内微小病变,宫腔镜检查联合宫腔搔刮术和单纯搔刮术均有助于提高反复种植失败患者的临床妊娠率,但前者与后者相比并未提高临床妊娠率。
[Abstract]:Objective to investigate the clinical significance of hysteroscopy and curettage in patients with recurrent implant failure. Methods 205 infertile patients who failed to implant repeatedly were divided into 3 groups according to whether or not hysteroscopy and uterine cavity curettage were performed: group A: group B: group C: no intervention measures were given. Group A was divided into normal uterine cavity shape group (A 1 group) and abnormal uterine cavity shape group (A 2 group) according to the examination. The hysteroscopy examination of group A was analyzed, and the clinical pregnancy rate, embryo implantation rate and adverse pregnancy rate of 4 groups were compared. Results the clinical pregnancy rate and embryo implantation rate were significantly higher in group A (57.4%) than that in group C (42.6%), including endometritis, endometrial polyps and hyperplasia, uterine cavity adhesion, and so on. The clinical pregnancy rate and embryo implantation rate in group A 1 were significantly higher than those in group C, and the clinical pregnancy rate and embryo implantation rate in group A 1 were significantly higher than those in group C. The difference was statistically significant (P 0.05), but there was no significant difference between group A 1 A 2 and group B. Conclusion hysteroscopy can show minimal changes in uterine cavity. Hysteroscopy combined with intrauterine curettage and simple curettage can improve the clinical pregnancy rate of patients with repeated implantation failure, but the former has not increased the clinical pregnancy rate compared with the latter.
【作者单位】：安徽医科大学第一附属医院生殖中心;
【基金】：卫生部公益性行业科研专项(编号:201402004) 国家自然科学基金青年基金项目(编号:81501232)
【分类号】：R714.8

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