网络首发:2012-11-20,
纸质出版:2012
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宫腔镜治疗不同形态子宫中隔对生育能力的影响分析[J]. 中山大学学报(医学科学版), 2012,33(6).
Retrospective Analysis of Hysteroscopy in 95 patients with Different Types ofUterine Septum[J]. Journal of Sun Yat-sen University (Medical Sciences), 2012, 33(6).
【目的】 了解不同形态子宫中隔术后的妊娠率及其妊娠结局,探讨宫腔镜手术治疗各种形态子宫中隔对生育能力的影响。【方法】 95例患者均行宫腔镜下子宫中隔切除术。根据患者症状分为不孕组及反复流产组,分别进行术后随访,了解术后是否妊娠以及妊娠距离手术时间、妊娠结局。并按三维B超诊断的宫腔形态分为“Y型宫腔”、“V型宫腔”、“X型宫腔”三组,比较组间差别。所有患者术后均放置宫内节育器3个月+激素序贯人工周期处理预防宫腔粘连。【结果】 不孕组主要为V型宫腔(46.2%),流产组主要为Y型宫腔(80.4%),两组比较差异有统计学意义(P < 0.05)。不孕组V型宫腔较其他组受孕率明显升高(P < 0.05)。流产组术前术后妊娠结局比较差异有统计学意义(P < 0.05),不同宫腔形态组间比较差异无统计学意义(P > 0.05)。两组产后无1例发生胎盘粘连、植入、产后大出血等产科并发症。术后出现1例宫腔粘连行二次宫腔镜手术。【结论】 子宫中隔长度未达宫腔深度1/2者主要症状为反复流产,中隔长度超过宫腔深度1/2的者主要症状为不孕;完全中隔症状有不孕及反复流产。宫腔镜下子宫中隔切除术是治疗子宫中隔畸形的理想方法,可明显改善妊娠结局。
【Objectives】 To analyze the treatment effect of hysteroscopic surgery for different types of uterine septum comprehensively, understanding of pregnancy after hysteroscopic uterine septum resection and its conception of time from the surgery, as well as miscarriage, premature delivery, and other symptoms. 【Method】 There were 95 patients accepted transcervical hysteroscopic resection of septum. The postoperative patients were followed up, mainly about whether the pregnancy and after pregnancy from the operation time, and pregnancy outcome. Symptoms were divided into groups according to infertility and recurrent abortion group, Each group was divided into “Y-uterine cavity”, “V-uterine cavity”, “X-uterine cavity” by diagnosis of transvaginal three-dimensional B-ultrasound respectively. Three groups were compared between these groups. All patients were placed IUD 3 months + hormone cycle sequential manual handling prevention of intrauterine adhesions. 【Results】 The symptoms caused by different uterine septum showed significantly difference (P < 0.05). V-uterine cavity had a significant higher pregnancy rate than other groups in group infertility (P < 0.05). The pregnancy outcome in group recurrent abortion before and after surgery was significant (P < 0.05), between groups of different uterine cavities were not significant (P > 0.05). One case of intrauterine adhesion was developed after surgery. 【Conclusion】 1. Uterine septum below the depth of uterine cavity length of 1 / 2 of the main symptoms in patients is recurrent abortion; uterine septum is above the depth of 1 / 2 of the main symptoms in patients is infertility. 2. Hysteroscopic uterine septum resection (TCRS) is the an ideal way to treat uterine septum malformation to significantly improve the pregnancy outcome.
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