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目的探讨复发性流产(RSA)与宫腔镜检查发现子宫异常结果的关系。方法对广州医科大学附属第三医院妇科门诊自2013年1月至2014年12月227例RSA患者的宫腔镜检查的临床资料进行统计学分析。结果227例RSA患者中,子宫腔粘连51例(22.47%),子宫内膜息肉12例(5.29%),子宫腔畸形7例(3.08%),子宫内膜炎3例(1.32%),子宫粘膜下肌瘤1例(0.44%)。RSA患者流产后月经量与宫腔粘连的程度有关,差异有统计学意义(χ2=15.035,P<0.05)。RSA清宫次数增加宫腔粘连发生率,差异有统计学意义(χ2=30.678,P<0.05)。关联分析提示宫腔粘连程度与月经前后量的变化存在显著正相关性(R=0.611),与清宫术次数存在低度正相关性(R=0.361)。结论宫腔镜检查能及早发现RSA患者宫腔病变,可作为RSA常规检查项目。
Objective To investigate the relationship between recurrent spontaneous abortion (RSA) and uterine abnormalities detected by hysteroscopy. Methods The clinical data of 227 hysteroscopy patients with RSA from the Third Affiliated Hospital of Guangzhou Medical University from January 2013 to December 2014 were analyzed statistically. Results Among 227 patients with RSA, 51 cases (22.47%) had endometrial adhesions, 12 cases (5.29%) had endometrial polyps, 7 cases (3.08%) had uterine cavity deformity, 3 cases (1.32%) had endometritis, Submucous myoma in 1 case (0.44%). The amount of postmenopausal menstruation in RSA patients was related to the degree of uterine adhesions (χ2 = 15.035, P <0.05). The incidence of intrauterine adhesions increased with the number of RSA cleansing, the difference was statistically significant (χ2 = 30.678, P <0.05). Correlation analysis showed that there was a significant positive correlation (r = 0.611) between the degree of intrauterine adhesions and the amount before and after menstruation, there was a low positive correlation with the number of hysterisis (R = 0.361). Conclusions Hysteroscopy can detect uterine cavity lesions of RSA patients early and can be used as routine examination items of RSA.