子宫纵隔切开术治疗纵隔引起的流产与不孕疗效比较  

A comparison of effect of hysteroscopic metroplasty combined laparoscopy in septate uterus patients with infertility and miscarriage

作　　者：冯淑英[1] 陈湘云[1] 陈京力[1] 梁玉萍[1] 翁梅英[1] 杨冬梓[1] 罗启东[1] 

机构地区：[1]中山大学第二附属医院,广东广州510120

出　　处：《中国内镜杂志》2005年第9期967-969,共3页China Journal of Endoscopy

摘　　要：目的比较宫腔镜联合腹腔镜切开子宫纵隔术治疗由纵隔引起的流产、不孕的效果。方法追踪在该院行该术治疗的患者62例,统计手术时间、出血量、手术并发症及术后活产率、流产率、妊娠期并发症、分娩方式等。结果成功随访51例,流产组28例和不孕组23,两组术后的活产率分别是85.7%和69.5%,两组比较差异无显著性(P>0.05),两组从手术至分娩时间的中位数是22.53和23.10个月,两组比较差异无显著性(P>0.05)。子宫纵隔切开术后妇女妊娠、先兆流产发生率、臀位发生率、早产率和剖宫产率均高于一般妇女。有1例发生不完全子宫破裂。结论宫腔镜联合腹腔镜治疗由纵隔引起的流产、不孕的效果相似;子宫纵隔患者术后妊娠的并发症包括先兆流产、胎位异常、早产等的发生率较高,剖宫产的几率较大。且术后妊娠有子宫破裂的危险。[Objective] The foUowing retrospective study intended to evaluate the efficacy of a hysteroscpic metroplasty in septate uterus patients with infertihty and miscarriage. [Methods] 34 septate uterus patients with miscarriage and 28 septate uterus patients with infertility had undergone a hysteroscpic metroplasty combined laparoscopy. Clinical data recorded included： the operative time, the amount of bleeding, complications of operative hysteroscopy, giving birth rate, miscarriage rate, complications of pregnancy, the pattern of delivery. [Results] The giving birth rates of miscarriage group and infertility group are 85.7% and 69.5% respectively （P 〉0.05）. The median periods from operation to delivery of two groups are 22.53 months and 23.10 months （P 〉0.05）. The threatened abortion rate, the breech presentation rate, the premature delivery rate, the cesarean section rate are higher than normal women （P 〈0.05）. One case was found an early stage of uterine rupture at cesarean delivery. [Conclusions] Hysteroscopic metroplasty combined laparoscopy has been shown to be a safe, simple and effective method of treating the septate uterus patients with infertility and miscarriage. But the pregnant complication rates of post-operation women are higher than that of normal women. Uterine rupture may occur in subsequent pregnancy.

关 键 词：宫腔镜 腹腔镜 子宫畸形 流产 不孕 

分 类 号：R711[医药卫生—妇产科学]