稽留流产、高危流产处理方式选择的重要性

The Importance of the Treatment of Missed Abortion and High Risk Abortion

摘要: 目的：探讨宫腔镜在早期人工流产中的应用及降低术中及术后并发症的价值。方法：采用回顾性分析方法选取2017年10月至2018年12月在我院门诊诊断早期人工流产，并接受终止妊娠患者1438例，其中宫腔镜下人工流产661例(其中稽留流产179例、高危人工流产482例)，无痛人工流产501例，药物流产276例为研究对象。结果：661例接受宫腔镜检查 + 人工流产患者中，终止妊娠率100.00%。术中发现宫腔粘连18例，子宫瘢痕憩室19例，子宫不完全纵隔4例，宫腔息肉2例，术中放置宫内节育器114例。术后一周复查B超，宫腔镜流产组，宫腔积血4例，无宫腔残留的发生，人工流产组，宫腔残留8例，药物流产组宫腔残留67例。结论：宫腔镜检查不仅明确宫腔内妊娠组织着床位置，同时可了解宫腔形态，明确有无宫腔畸形及宫腔残留，而且对于高危妊娠是一种可安全、有效、可靠解除妊娠的微创方法，更利于降低术后近期并发症的发生，有益保护女性生殖健康。

Abstract: Objective: To investigate the application of hysteroscopy in early induced abortion and the value of reducing intraoperative and postoperative complications. Methods: Retrospective analysis method to select in October 2017 to December 2018 in our hospital clinic diagnosis early abortion, and subject to termination of pregnancy, 1438 cases of patients, among which 661 were under hysteroscopy abortion (missed abortion in 179 cases, 482 cases of high-risk abortion), 501 cases of painless abortion, 276 cases of medical abortion as the research object. Results: Pregnancy termination rate was 100.00% in 661 patients undergoing hysteroscopy + induced abortion. Intraoperative findings included 18 cases of intrauterine adhesions, 19 cases of uterine scar diverticulum, 4 cases of uterine incomplete mediastinum, 2 cases of uterine polyps, and 114 cases of intrauterine iUd placement. One week after the operation, b-ultrasonography was rechecked, hysteroscopic abortion resulted in 4 cases of uterine hemorrhage, and no residual uterine cavity occurred, induced abortion resulted in 8 cases of residual uterine cavity, and medical abortion resulted in 67 cases of residual uterine cavity. Conclusion: Hysteroscopy examination not only clear intrauterine pregnancy tissue implantation position, uterine cavity form, at the same time can understand clear presence of uterine malformation and caused by intrauterine residue, and for high-risk pregnancy is a safe, effective and minimally invasive method of reliable terminate the pregnancy, more conducive to reduce the postoperative complications of the recent, beneficial to protect women’s reproductive health.