宫腔镜在宫腔因素不孕症患者中的应用效果观察

Observation on the application effect of hysteroscopy in infertile patients induced by uterine factors

目的：探讨宫腔镜在宫腔因素不孕症患者中的应用效果。方法：选取2010年1月-2013年2月该院收治的648例宫腔因素不孕症患者为研究对象,另选取同期在该院就诊的89例非宫腔因素不孕症患者作为对照。宫腔因素不孕症患者行宫腔镜治疗,非宫腔因素不孕症患者未行宫腔镜治疗。观察各宫腔因素不孕症患者妊娠情况、妊娠结局及并发症情况。结果：与非宫腔因素不孕症患者妊娠率（12.36%）比较,经宫腔镜治疗后的宫腔粘连（44.30%）、子宫内膜息肉（62.29%）、子宫黏膜下肌瘤（50.43%）、子宫纵隔（59.05%）、宫腔异物（46.88%）所致不孕症患者妊娠率均明显升高,差异有统计学意义（χ^2=4.71,P〈0.05;χ^2=9.12,P〈0.05;χ^2=7.36,P〈0.05;χ^2=5.67,P〈0.05;χ^2=8.69,P〈0.05）。宫腔因素原发性不孕妊娠率为51.80%（187/361）,继发性不孕妊娠率为57.84%（166/287）,两者均明显高于非宫腔因素不孕症患者（χ^2=7.21,P〈0.05;χ^2=6.59,P〈0.05）,两者比较差异无统计学意义（χ^2=1.35,P〉0.05）。术后并发症发生率为1.69%（11/648）,经及时有效治疗后均治愈。结论：宫腔镜治疗可提高各种宫腔因素不孕症患者的妊娠率,流产率极低,并发症少,可作为宫腔因素不孕症治疗的首选方法。

Objective： To explore the application effect of hysteroscopy in infertile patients induced by uterine factors. Methods： From January 2010 to February 2013, 648 infertile patients induced by uterine factors were selected from this hospital as study group, 89 in- fertile patients induced by other factors were selected as control group. The patients in study group were treated with hysteroscopy, while the patients in control group were not treated with hysteroscopy. The pregnancy rates, pregnancy outcomes and complications in the two groups were observed. Results： Compared with the pregnancy： rate in control group （12. 36% ）, the pregnancy rates among infertile patients in- duced by intrauterine adhesion, endometrial polyp, submucosal myoma of uterus, uterine mediastinum and intrauterine foreign body in study group were 44. 30%, 62. 29%, 50.43%, 59. 05% and 46. 88%, respectively, there were statistically significant differences （χ^2 =4. 71, P〈0.05;x2=9.12, P〈0.05;χ^2=7.36, P〈0.05;χ^2=5.67, P〈0.05;x2=8.69, P〈0.05）. In study group, the pregnancy rates of patients with primary infertility and secondary infertility were 51.80% （ 187/361 ） and 57. 84% （ 166/287 ）, respectively, which were statistically significantly higher than that in control group （χ^2 = 7.21,P 〈0. 05 ; χ^2 = 6. 59, P 〈0. 05 ）, but there was no statistically significant difference between the patients with primary infertility and the patients with secondary infertility in study group （χ^2 = 1.35, P 〉 0. 05） . The incidence rate of postoperative complications was 1.69% （ 11/ 648）, all the patients were cured after timely and effective treatment. Conclusion： Hysteroscopy can improve the pregnancy rate of infertile patients induced by various uterine factors, the abortion rate is extremely low, the complications are few, which can be used as the preferred method for treatment of infertility induced by uterine factors.