国际妇产科学杂志

国际妇产科学杂志 ›› 2016, Vol. 43 ›› Issue (5): 597-600.

• 论著 • 上一篇    

合并阴道纵隔双宫颈的完全中隔子宫27例临床分析

马晓黎，刘雨声，郭银树，段华   

  1. 100006 北京，首都医科大学附属北京妇产医院妇科微创中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2016-10-15 发布日期:2016-10-15
  • 通讯作者: 段华

Clinical Analysis of Hysteroscopic Electroresection Treatment Combined with Laparoscopy in 27 Patients with Complete Septum Uterus Duplicated Cervix and Vaginal Septum

MA Xiao-li，LIU Yu-sheng，GUO Yin-shu，DUAN Hua   

  1. Department of Gynecology Minimally Invasive Center，Beijing Obstetrics and Gynecology Hospital，Capital Medical University，Beijing 100006，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2016-10-15 Online:2016-10-15
  • Contact: DUAN Hua

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摘要： 目的：探讨宫腹腔镜联合矫治合并阴道纵隔双宫颈的完全子宫中隔的临床效果。方法：收集2012—2013年首都医科大学附属北京妇产医院妇科微创中心27例宫腹腔镜联合矫治合并阴道纵隔双宫颈的完全中隔子宫患者的临床资料，其中原发不孕7例，自然流产10例，稽留流产3例，不良孕史7例。结果：27例患者一次手术成功率为100%，未发生术中、术后并发症。27例随访30～53个月，平均（41.56±6.33）个月。足月活产18例，早产1例，自然流产2例，未孕3例，因胎儿畸形引产1例，术后1例失访，3例术后因个人或疾病原因暂无妊娠计划，一直避孕。本组患者妊娠率由术前52.17%（11/23）上升至术后86.96%（20/23， χ2=6.33，P=0.01），而活产率由术前0（0/23）上升至术后82.61%（19/23，P=0.000），流产率由术前47.83%（11/23）下降至术后8.70%（2/23， χ2=6.86，P=0.008），差异均有统计学意义。结论：宫腹腔镜联合矫治合并阴道纵隔双宫颈的完全中隔子宫安全、有效，能显著改善患者生殖预后，提高妊娠率和活产率，降低流产率。

关键词: 宫腔镜, 腹腔镜, 苗勒管, 阴道纵隔双宫颈, 完全中隔子宫

Abstract: Objective: To evaluate the clinical effect in patients with complete septum uterus, duplicated cervix and vaginal septum after hysteroscopic electroresection combined with laparoscopy. Methods：We retrospectively analyzed the clinical data of 27 patients with complete septum uterus, duplicated cervix and vaginal septum undergoing hysteroscopic resection combined with laparoscopy from 2012 to 2013 in Gynecological Minimal Invasive Center in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University. There are primary infertility 7, nature abortion 10, missed abortion 4, abnormal childbearing history 7. Results: The success rate of surgery was 100% without intra- or post-operative complications. The duration of post-operative follow-up ranged from 30 to 53 months, with an average of （41.56±6.33） months. There are full-term delivery 18 cases, premature delivery 1, nature abortion 2, inferlity 3, induced labor due to fetal anomaly 1, lost 1, have no birth plan 3. The pregnancy rate of patients with complete uterine septum increased from 52.17% （11/23, pre-operation） to 86.96% （20/23, post-operation, χ2=6.33, P=0.01）. The full-term live birth rates increased from 0（0/23, pre-operation） to 82.61% （19/23, post-operation, P=0.000）. The spontaneous abortion rates decreased from 47.83% (11/23, pre-operation） to 8.70% （2/23, post-operation, χ2=6.86, P=0.008）. Conclusions: Hysteroscopic resection of uterine septum is safe and effective. For patients with complete uterine septum, hysteroscopic resection of septum combined with laparoscopy can increase the full-term live birth rate, decrease spontaneous abortion rate, and improve patients' reproductive prognosis.

Key words: Hysteroscopes, Laparoscopes, Mullerian ducts, Vaginal septum and duplicated cervix, Complete septum uterus