宫腔镜对早孕流产后宫内残留物的诊治意义

目的评价宫腔镜对早孕流产后宫内残留物诊治的临床意义。方法回顾性分析早孕流产后阴道流血、超声检查均提示有宫内占位的行宫腔镜检查术的患者45例。结果宫腔镜诊断宫内陈旧血块残留8例,蜕膜残留25例,绒毛残留12例。与病理结果比较,宫腔镜诊断陈旧血块残留及绒毛残留的符合率为100%,诊断蜕膜残留的符合率为76%。34例在宫腔镜检查的同时行清宫术,11例因残留时间较长,收入院后进行相应处置。随访时间至月经正常来潮为止。45例患者均月经来潮,最长为3个月经周期后月经恢复正常。术后无宫腔感染、宫腔粘连及子宫穿孔等合并症发生。结论宫腔镜可诊断宫内是否有妊娠残留物及残留物的位置、形状、大小,并在直视下对宫内妊娠物残留的患者进行确切有效的治疗。

Value of hysteroscopy in diagnosis and treatment of residuum in uterus after early artificial abortion

Objective To investigate the clinical value of hysteroscopy in diagnosis and treatment of residuum in uterine cavity after early artificial abortion. Methods Forty five patients suffering vaginal bleeding after early artificial abortion were analyzed retrospectively, all of their ultrasonic images showed mass in uterine cavity and they accepted hysteroscopy examination. Results Thirty seven cases were diagnosed pregnancy residuum, including 25 cases of decidiuas and 12 cases of villus. The rest 8 cases were diagnosed obsolete blood in uterine cavity. Comparing with pathological resuits, the coincidental rate of hysteroscopy in diagnosing obsolete blood and villus were all 100 %, and 76 % for declduas. 34 patients accepted curettage simultaneously, 11 patients were treated in hospital because the pregnancy tissue has been in uterus for long time. All of the patients were followed up till normal menstruating. There was no complications such as infection, adhesion, perforation and so on. Conclusion Hysteroscopy can examine the existence of residuum and describe the position, shape and size of the residuum, it can also treat the residuum assuredly.