CAJ | 학술논문

目的：探讨在复发性流产患者中使用宫腔镜检查的特定时机。方法：回顾性收集我院妇科自2009年1月至2014年12月间收治的复发性流产患者341例的临床资料，按照流产次数分为3组：组1：2次流产；组2：3次流产；组3：≥4次流产。均接受宫腔镜检查，分析组间宫腔异常（先天或获得性）的差异性。结果：组1中101例（占62.7%）宫腔正常，42例（占26.1%）先天性异常，18例（占11.2%）获得性异常；组2中分别为，61例（占51.7%），35例（占29.7%），22例（占18.6%）；组3中此3项数据分别为，29例（占46.8%），18例（占29.0%），15例（占24.2%）。3组患者的宫腔镜检查结果差异无统计学意义（P=0.161）。结论：复发性流产患者中，特别是对难以承受再次流产的晚孕、高龄、焦虑的女性，在连续2次流产后，应将宫腔镜检查列为首选干预措施，积极发现并治疗宫腔异常以改善妊娠结局。
목적：탐토재복발성유산환자중사용궁강경검사적특정시궤。방법：회고성수집아원부과자2009년1월지2014년12월간수치적복발성유산환자341례적림상자료，안조유산차수분위3조：조1：2차유산；조2：3차유산；조3：≥4차유산。균접수궁강경검사，분석조간궁강이상（선천혹획득성）적차이성。결과：조1중101례（점62.7%）궁강정상，42례（점26.1%）선천성이상，18례（점11.2%）획득성이상；조2중분별위，61례（점51.7%），35례（점29.7%），22례（점18.6%）；조3중차3항수거분별위，29례（점46.8%），18례（점29.0%），15례（점24.2%）。3조환자적궁강경검사결과차이무통계학의의（P=0.161）。결론：복발성유산환자중，특별시대난이승수재차유산적만잉、고령、초필적녀성，재련속2차유산후，응장궁강경검사렬위수선간예조시，적겁발현병치료궁강이상이개선임신결국。
Objective:To discuss the appropriate time-window for diagnostic hysteroscopy in patients with recurrent miscarriage. Methods:A retrospective study on the clinical and hysteroscopic investigation of 341 cases with recurrent miscarriage was conducted. According to the number of miscarriages (2, 3, and 4 or more consecutive miscarriages), patients were divided into three groups, and all received diagnostic hysteroscopy for uterine anomalies. Congenital (septate uterus/subseptum, arcuate uterus, unicornuate uterus, uterine hypoplasia) and acquired uterine abnormalities (intrauterine adhesions, polyp and submucous myoma) were recorded. The hysteroscopic results were compared between the groups. Results:No anomalies, congenital and acquired abnor-malities in group 1, 2 and 3 were:101 (62.7%), 42 (26.1%), 18 (11.2%);61 (51.7%), 35 (29.7%), 22 (18.6%);29 (46.8%), 18 (29%), 15 (24.2%). No signiifcant differences were found in the three groups (P=0.161). Conclusion:Diagnostic hysteroscopy should be carried out after 2 consecutive miscarriages, in order to determine congenital and acquired uterine anomalies, ifnally improve pregnancy outcome. Especially in those older, anxious popula-tion who cannot venture to lose another pregnancy.