纵隔子宫的病因及诊治

doi:10.12280/gjfckx.20201206

摘要/Abstract

摘要：

纵隔子宫是先天性子宫畸形中最常见的类型,可能导致流产、早产和胎儿生长受限等不良妊娠结局。目前有关纵隔子宫的病因尚未明确,研究者试图通过基因水平、胚胎发育过程和子宫纵隔解剖结构的研究探究纵隔子宫的成因及导致不良妊娠结局的机制,但均不能完整揭示其形成原因,还需进一步探究。纵隔子宫可以通过超声诊断,随着诊断技术的发展,磁共振成像（magnetic resonance imaging,MRI）、三维超声技术使得纵隔子宫的诊断更为精准,但宫腔镜诊断仍是纵隔子宫诊断的金标准。由于目前子宫畸形的分类系统不同,对纵隔子宫的定义也有差异,因此往往导致不同的治疗结局,尽管有大量回顾性研究及前瞻性对照研究的数据支持采用经宫颈子宫纵隔切除术（transcervical resection of septum,TCRS）治疗纵隔子宫,但是否需要手术治疗仍需高质量的随机对照研究作为临床决策的支持。

关键词: 纵隔子宫, 子宫, 病因, 诊断, 治疗

Abstract:

Septate uterus is the most common type of congenital uterine malformation, which may lead to adverse pregnancy outcomes such as abortion, premature delivery and fetal growth restriction. At present, the etiology of septate uterus is not clear. The researchers try to explore the causes of septate uterus and the mechanism of adverse pregnancy outcome through the study of gene level, embryonic development process and anatomical structure of septate uterus, but they can not completely reveal the causes of its formation. Septate uterus can be diagnosed by ultrasound. With the development of diagnostic techniques, magnetic resonance imaging (MRI) and three-dimensional ultrasound technology make the diagnosis of septate uterus more accurate, but hysteroscopic diagnosis is still the gold standard for the diagnosis of septate uterus. Because the current classification system for uterine deformities is different and the definition of septate uterus is different, it often leads to different therapeutic outcomes. Although there are a large number of retrospective studies and prospective controlled studies supporting the treatment of septate uterus by transcervical resection of septum (TCRS), high-quality randomized controlled studies are needed to support clinical decisions.

Key words: Septate uterus, Uterus, Etiology, Diagnosis, Therapy

高丽, 夏恩兰. 纵隔子宫的病因及诊治[J]. 国际妇产科学杂志, 2021, 48(5): 588-591.

GAO Li, XIA En-lan. Progress in Diagnosis and Treatment of Septate Uterus[J]. Journal of International Obstetrics and Gynecology, 2021, 48(5): 588-591.

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