宫腔镜在不孕症诊治中的应用价值

The application value of hysteroscopy in the diagnosis and treatment of infertility

目的分析宫腔镜检查中发现不孕症患者的宫腔内病变类型,探讨宫腔镜检查在不孕症患者中的应用价值。方法回顾性分析本院272例不孕症患者的宫腔镜检查结果,按有无妊娠史分为原发不孕组(131例)及继发不孕组(141例),按有无IVF治疗分为IVF治疗失败组,无IVF治疗组,根据宫腔镜检查结果比较原发不孕与继发不孕组宫腔镜发现病变结果差异,比较IVF治疗失败组与无IVF治疗组间宫腔镜检查结果差异。结果 272例不孕症患者中,宫腔镜检查发现宫内病变172例,占63.24%。在原发性不孕组与继发性不孕组中,宫腔内病变的发生率比较差异无统计学意义,但原发性不孕组子宫内膜息肉的发生率高于继发性不孕组,继发性不孕组宫腔粘连的发生率高于原发不孕组,两组比较差异有统计学意义(P<0.05)。无IVF治疗组患者子宫内膜息肉及息肉样增生的发生率高于IVF治疗失败组患者,IVF治疗失败组患者宫腔无病变比例明显高于无IVF治疗组,差异有统计学意义(P<0.05)。结论不孕症患者中宫腔病变的发生率高,宫腔镜检查能够发现超声的检查发现不了的微小病变,在女性不孕症的诊治中有重要价值。

Objective to analyze the types of intrauterine lesions in infertile patients with hysteroscopy and to explore the application value of hysteroscopy in patients with infertility. Methods The hysteroscopy of 272 patients with infertility were analyzed retrospectively, and divided into primary infertility group （131 cases） and secondary infertility group （141 cases）according to the presence of pregnancy history, divided into IVF treat- ment failure groups, without IVF treatment group according to the presence of IVF treatment. Comparing the difference of intrauterine lesions be- tween the primary and secondary infertility, between IVF treatment failure and with IVF treatment group by the differences between hysteroscopy examination results. Results In 272 cases of infertility,172 cases of intrauterine lesion were detected by hysteroscopy, accounting for 63.24%. In primary group and secondary infertility group, no difference was found between the incidence of intrauterine lesions, but the incidence of endometrial polyps in primary infertility group is higher than secondary infertility group, a group of secondary infertility caused by intrauterine adhesions is higher than the incidence of primary infertility group, are similar between the two groups have statistical significaaace（P〈 0.05）. Patients who were not line of IVF treatment the incidence of endometrial polyps and polypoid hyperplasia patients are higher than line IVF treatment failure, line IVF treatment failure in patients with uterine cavity without pathological changes is notably higher than no IVF treatment group（P〈0.05）. Conclusion The incidence of uterine cavity lesions in infertility patients is high, Hysteroscopy can detect small lesions that are not detectable by ultrasound and hysteroscopy is of great value in the diagnosis and treatment of female infertility.