宫腔镜电切术治疗完全中隔子宫双宫颈阴道纵隔64例生殖预后分析  

Analysis of reproductive prognosis in 64 cases of complete septate uterus with duplicated cervix and longitudinal vaginal septum after hysteroscopic septum resection

作　　者：黄丽娜[1,2] 江静逸[1] 吴瑞瑾[1] 

机构地区：[1]浙江大学医学院附属妇产科医院,浙江杭州310006 [2]宁波市妇女儿童医院

出　　处：《中国实用妇科与产科杂志》2015年第2期142-144,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：2013年浙江省人口计生委立项课题(JSW2013-B011)

摘　　要：目的探讨宫腔镜下子宫中隔电切除术对完全中隔子宫、双宫颈、阴道纵隔患者的治疗效果。方法 2004年9月至2013年8月浙江大学医学院附属妇产科医院完全中隔子宫、双宫颈、阴道纵隔住院患者64例,均行宫腔镜下子宫中隔电切除术及阴道纵隔切除术,分为反复流产组(26例)和不孕组(38例),电话或门诊随访妊娠结局。结果反复流产组25例妊娠,累计妊娠31次,自然流产率由术前83.1%(54/65)下降为41.9%(13/31),足月产率、早产率和活产率分别为35.5%(11/31)、19.3%(6/31)和54.8%(17/31),与术前比较差异均有统计学意义(P<0.05);不孕组18例妊娠,妊娠率47.4%(18/38),其中12例足月分娩。研究对象中早产及足月产共32例,早产率28.1%(9/32),足月产率71.9%(23/32)。研究对象胎盘粘连、植入发生率21.9%(7/32),产后出血发生率25.0%(8/32)。结论宫腔镜下子宫中隔电切除术可提高完全中隔子宫、双宫颈、阴道纵隔患者的妊娠率及生殖预后。Objective To evaluate the reproductive prognosis of patients with duplicated cervix and longitudinal wtgi- nal septum undergoing hysteroseopic septum resection of the complete septate uterus.Methods Sixty-tour patients with complete septate uterus and duplicated cervix and longitudinal vaginal septum underwent hysteroscopic septum resection. All patients were divided into recurrent abortion group （n=26） and infertility group （n=38） according to their obstetrical situation. The pregnancy outcomes of these patients were followed up by telephone or out-patient clinic.Results In recurrent abortion group, there were 25 women with 31 pregnancies.The abortion rate declined fi＇om 83.1% （54/65）to 41.9% after operation （13/31 ）.The full-term pregnancy rate, premature delivery and living birth increased to 35.5%（ 11/ 31 ）,19.3 %（6/31）and 54.8%（17/31 ）respectively （P〈0.05）. in infertile group, there were 18 women pregnant （18/38）,in- cluding 12 full-term labor. In the research objects,the cases of premature labor and full-term labor were 32 .The prema- ture delivery rate was 28.1%（9/32）and the full-term pregnancy rate was 71.9%（23/32）.In the research objects,the inci- dence of placental adherence was 21.9% （7/32）,and the incidence of postpartum hemorrhage was 25.0% （8/32）. Conclu- sions The pregnancy rates and reproductive prognosis in the women with complete septate uterus and duplicated cervix and longitudinal vaginal septum is improved after hysteroscopic septum resection.

关 键 词：完全中隔子宫 双宫颈 阴道纵隔 宫腔镜电切除术 生殖预后 

分 类 号：R711.1[医药卫生—妇产科学]