目的:对有复发性流产史患者子宫内环境改变情况进行研究,以了解复发性流产病史患者宫腔内可能致病的因素。方法:对155例有复发性流产病史患者行宫腔镜检查。子宫纵隔、鞍形子宫、双角子宫、单角子宫和子宫发育不全(幼稚子宫)为先天性子宫异常;宫腔粘连、子宫内膜炎、宫腔息肉和黏膜下肌瘤为获得性子宫异常。结果:发现正常宫腔51例(32.3%),宫内病变例104例(66.6%),其中先天性宫腔病变32例(20.6%),获得性宫腔病变72例(46.4%),在获得性宫腔异常中,宫腔粘连48例(31.0%),子宫内膜炎21例(13.5%),宫腔息肉17例(10.96%),黏膜下肌瘤5例(3.2%)。3次及3次以上复发性流产患者较1次复发性流产患者获得性宫腔异常显著增多(P<0.05)。结论:有复发性流产史患者行宫腔镜检查是必要的,宫腔粘连也是引起复发性流产的一个重要原因。 Objective: To study the changes of intrauterine environment in patients with recurrent spontaneous abortion to understand the possible pathogenesis of uterine cavity in patients with recurrent spontaneous abortion. Methods: Hysteroscopy was performed in 155 patients with recurrent miscarriage history. Uterine mediastinal, saddle-shaped uterus, double angle uterus, single angle uterus and uterine hypoplasia (naive uterus) for congenital uterine anomalies; intrauterine adhesions, endometritis, uterine polyps and submucosal fibroids are acquired uterine anomalies . Results: 51 cases (32.3%) were found in normal uterine cavity, 104 cases (66.6%) were intrauterine lesions, including 32 cases of congenital uterine lesions (20.6%) and 72 cases of acquired uterine lesions (46.4%). Of the acquired intrauterine abnormalities, 48 ​​(31.0%) had intrauterine adhesions, 21 (13.5%) had endometritis, 17 (10.96%) had uterine polyps, and 5 (3.2%) had submucosal fibroids. Patients with recurrent spontaneous abortion more than 3 times had more abnormal uterine cavity than those with 1 recurrent spontaneous abortion (P <0.05). Conclusion: Hysteroscopy in patients with recurrent spontaneous abortion is necessary, and intrauterine adhesions are also an important cause of recurrent spontaneous abortion.