摘要
目的 探讨稽留流产清宫术后宫腔黏连的术式相关影响因素。方法 回顾分析2022年1月至2023年12月接受四种不同清宫术式的150例患者，术后6个月行宫腔镜随访，记录黏连发生率及相关术中参数。结果 总黏连率为25.33%，传统刮宫组最高（42.86%），宫腔镜引导组最低（5.71%）；Logistic回归分析显示，盲刮、重复清宫、吸刮时间≥7分钟和负压≥300 mmHg为独立危险因素（P<0.05）。结论 清宫术式及术中操作方式对宫腔黏连风险具有显著影响，术式优化和操作规范是关键。
关键词： 稽留流产；清宫术；宫腔黏连；术式；负压吸引
Abstract
Objective To explore surgical approach-related risk factors for intrauterine adhesions (IUA) following curettage in patients with missed abortion. Methods A retrospective analysis was conducted on 150 patients who underwent one of four different curettage procedures between January 2022 and December 2023. All patients received hysteroscopic follow-up at 6 months to assess adhesion incidence and collect intraoperative parameters. Results The overall adhesion rate was 25.33%, with the highest rate in the traditional sharp curettage group (42.86%) and the lowest in the hysteroscopy-guided group (5.71%). Logistic regression analysis identified blind curettage, repeated curettage, suction time ≥7 minutes, and vacuum pressure ≥300 mmHg as independent risk factors (P<0.05). Conclusion The type of curettage and intraoperative technique significantly affect the risk of IUA, emphasizing the importance of surgical optimization and procedural precision.
Key words： Missed abortion; Curettage; Intrauterine adhesion; Surgical method; Vacuum aspiration
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