国际妇产科学杂志

国际妇产科学杂志 ›› 2016, Vol. 43 ›› Issue (2): 207-209.

• 论著 • 上一篇    下一篇

宫腔镜治疗子宫纵隔的产科结局分析

王贺，杨清，毕芳芳   

  1. 110044 沈阳，中国医科大学附属盛京医院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2016-04-15 发布日期:2016-04-15

Obstetrical Outcome Analysis of Hysteroscopic Treatment of Uterus Septum

WANG He，YANG Qing，BI Fang-fang   

  1. Department of Obstetrics and Gynecology，Shengjing Hospital of China Medical University，Shenyang 110004，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2016-04-15 Online:2016-04-15

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摘要： 目的：探讨宫腔镜子宫纵隔电切术后患者的产科结局。方法：收集231例行宫腔镜子宫纵隔电切术患者的信息，电话随访患者术后恢复情况及妊娠情况。结果：所有患者均于腹腔镜或超声监视下一次性完成手术，术中无子宫穿孔、大出血等并发症发生，术后电话随访6～30个月，月经量均无明显改变，无宫腔粘连发生。161例患者于术后2～25个月成功妊娠，妊娠率69.7%（161/231）；21例患者自然流产，流产率13.0%（21/161）；14例患者因胎膜早破早产，早产率10.0%（14/140）。不同年龄组妊娠率相比较，术后妊娠率均高于术前妊娠率，差异有统计学意义（P＜0.05）。低年龄组术后妊娠率虽较高年龄组升高，但差异无统计学意义（P＞0.05）。结论：宫腔镜下子宫纵隔电切术能够有效改善患者的产科结局，明显提高妊娠率及活产率，降低流产率。对于早期发现纵隔子宫畸形的患者，应尽早手术治疗，提高妊娠率。

关键词: 宫腔镜检查, 电外科手术, 子宫, 产科结局

Abstract: Objective：To investigate the reproductive outcome after hysteroscopic resection of uterine septum in women with septate uterus. Methods：Clinical data of 231 patients who have received hysteroscopic septum resection in our hospital, follow-up of these patients with postoperative and reproductive outcome. Results：All patients complete the operation under laparoscopy or ultrasound surveillance, and no complications such as perforation or bleeding occurred. No obvious changes in menstruation and no intrauterine adhesions occurred at 6-30 months follow-up. 161 patients were pregnant at 2-25 months after the surgery, the pregnancy rate was 69.7% (161/231). 21 patients had spontaneous abortion, the abortion rate was 13% (21/161). 14 patients had preterm birth because of premature rupture of membrane, preterm birth rate was 10% (14/140). The pregnancy rate of different age groups were compared, and it was higher than that before operation, and it was more significant in the low age group. Conclusions：In hysteroscopic resection of uterrus septum can effectively improve the obstetrical outcome, improve the pregnancy rate and the live birth rate, and reduce the abortion rate. Patients who had found uterrus septum should be treated as early as possible to improve the pregnancy rate.

Key words: Hysteroscopy, Electrosurgery, Uterus, Obstetrical outcome