目的 探讨宫腔镜电切术在特殊类型稽留流产治疗中的作用.方法 结合病史、B超及宫腔镜检查确诊的特殊类型稽留流产患者58例,随机分为两组,研究组30例,行宫腔镜下稽留流产组织电切术;对照组28例,行清官术,清官后立即宫腔镜检查治疗效果.结果 研究组30例患者宫腔镜电切术后完全切净者29例,完全清除率为96.67％；对照组28例,清宫后完全清除稽留流产组织仅13例,15例未清净者宫腔镜复查宫腔内仍有大量稽留流产组织,完全清除率为46.43％,两组对比,差异有显著性(P＜0.05).完全清除患者术中出血量比较,研究组明显少于对照组；分泌中期子宫内膜厚度研究组明显大于对照组；月经恢复时间研究组明显早于对照组；差异均有显著性(均P ＜0.05).两组患者手术时间差异无显著性(P＞0.05).结论 官腔镜电切术可能是治疗特殊类型稽留流产的最佳方法,在特殊类型稽留流产的治疗中发挥重要作用.%[Objective] To investigate the application of transcervical resection by hysteroscopy in special missed abortion. [Methods] 58 women with special missed abortion were divided into two groups randomly, 30 patients of study group were treated by electrotomy with forceps under hysteroscope. The other 28 patients of control group were treated by conventional dilatation and curettage (D&C). [ Results ] Complete removal of the residual tissue was achieved in 29 of 30 patients in study group (96.67%). While 13 of 28 patients in control group were removed completely (46.43%), 15 of 28 patients in control group were ascertained with a lot of retained tissues of conception after D&C by reexamination of hysteroscopy. The difference between the two groups was significant (P< 0.01). There were significant differences between the two groups in volume of bleeding during the operation, endome- trial thickness of midcycle in the secretory phase and recovery time of menstruation. The operation time between the two groups had no significant difference. [ Conclusions ] Application of transcervical resection by hysteroscopy may be the best treatment of special missed abortion. It may play an important role in the treatment of the special missed abortion.
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