子宫内膜病变不孕患者的诊治

Diagnose and treatment for endometrium disorders in infertility women

目的探讨阴道超声和宫腔镜检查对不孕患者子宫内膜病变的诊断价值。方法分析2006年1月至2007年12月我院部分子宫内膜病变不孕患者的资料(156例)。对自然周期超声监测内膜回声异常的52例行宫腔镜检查,超声检查内膜正常者进入促排卵周期后25例出现内膜异常情况不孕者,常规行宫腔镜检查。结果自然周期超声发现的异常内膜52例,经宫腔镜确诊为异常45例占86.54%,促排卵周期超声发现的异常内膜25例,经宫腔镜确诊3例异常(12%)。结论自然周期超声和宫腔镜检查是发现内膜病变的重要方法;促排卵周期超声发现的内膜增厚、不均匀与内膜对激素的过度反应有关,宫腔镜对这种内膜病变的诊断价值有待深入研究。

Objective To investigate the diagnostic value of transvaginal sonography and hysteroscopy for the endometri -um disorders in infertility women . Methods A total of 156 infertility women in Taixing Hospital from January 2006 to December 2007 were enrolled in this study. Fifty - two cases of abnormal endometrial echoes in natural cycles and 25 cases of abnormal endometrial echoes in COH cycles underwent the examination of hysteroscopy. Results The coincidence rate was 86. 54% in find- ing the abnormal endometrium changes between transvaginal sonography and hysteroscopy and the coincidence was 12% in COH cycles. Conclusion Both transvaginal sonography and hysteroscopy can be served as important methods in natural cycles to monitor the endometrium disorders. Due to the super - reaction of endometrium tohormones in COH cycles, the value of hysteroscopy in the finding of endomerium disorders should be further investigated.