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目的:探讨宫腔镜检查在不孕症诊治中的应用价值。方法:回顾性分析实施宫腔镜检查的不孕症患者的病例资料。结果:12 003例患者中,原发不孕762例(38.0%),继发不孕1 241例(62.0%)。2宫腔镜检查显示有宫腔内病变者757例(37.8%),其中原发不孕274例,继发不孕483例,原发不孕和继发不孕组宫腔病变的发生率无统计学差异(P>0.05)。3宫腔内病变分别为:子宫内膜息肉(EP)、子宫内膜增殖症、宫腔粘连(IUA)、子宫内膜结核、子宫畸形、子宫内膜炎、黏膜下肌瘤、子宫内膜癌和宫腔异物9类,原发不孕症中EP、内膜结核、子宫内膜增殖症的发病率均高于继发不孕症组(P<0.05)。继发不孕症中宫腔粘连的发生率明显高于原发不孕症组(P<0.01)。42 003例患者中有体外受精-胚胎移植(IVF-ET)失败病史的182例,其中宫腔内有病变93例(51.1%),显著高于无IVF-ET失败病史者的宫腔内病变率(37.8%)(P<0.01)。结论:不孕症患者的宫腔内病变发生率接近40%,EP是原发不孕症患者最常见的宫腔内病变类型;IUA是继发不孕症患者最常见的宫腔内病变类型。对不孕症患者尤其是有过IVF-ET失败病史的患者,进行宫腔镜检查是非常必要的。
Objective: To explore the value of hysteroscopy in diagnosis and treatment of infertility. Methods: Retrospective analysis of hysteroscopy in infertility patients data. RESULTS: Of the 12 003 patients, 762 (38.0%) had primary infertility and 1 241 (62.0%) had secondary infertility. 2 hysteroscopy showed intrauterine lesions were 757 cases (37.8%), of which 274 cases of primary infertility, secondary infertility 483 cases of primary infertility and secondary infertility group the incidence of uterine lesions No statistical difference (P> 0.05). 3 intrauterine lesions were: endometrial polyps (EP), endometrial hyperplasia, intrauterine adhesions (IUA), endometrial tuberculosis, uterine malformations, endometritis, submucosal fibroids, endometrial There were 9 types of cancer and uterine foreign bodies, the incidences of EP, endometrial tuberculosis and endometrial hyperplasia in primary infertility were higher than those in secondary infertility (P <0.05). Secondary infertility in the incidence of intrauterine adhesions was significantly higher than the primary infertility group (P <0.01). Of the 42 003 patients, 182 had a history of failure of in vitro fertilization-embryo transfer (IVF-ET), of which 93 (51.1%) had intrauterine lesions, which were significantly higher than those with no history of IVF-ET failure Rate (37.8%) (P <0.01). Conclusion: The incidence of intrauterine lesions in infertility patients is close to 40%. EP is the most common type of intrauterine lesions in patients with primary infertility. IUA is the most common type of intrauterine lesions in patients with secondary infertility . For infertility patients, especially those with a history of failed IVF-ET, hysteroscopy is necessary.