宫腔镜子宫中隔切除术对子宫中隔合并不孕症及复发性流产患者的预后观察  

Observation on the effect of hysteroscopic transcervical resection of septa on prognosis of patients with uterine septum combined with infertility and recurrent spontaneous abortion

作　　者：郭政[1] 王丽英 李华[1] 

机构地区：[1]山西中医学院,山西太原030024 [2]山西现代妇产医院,山西太原030024

出　　处：《中国妇幼保健》2016年第21期4519-4521,共3页Maternal and Child Health Care of China

基　　金：山西省科技厅科技攻关项目(20140313009-8)

摘　　要：目的探讨宫腔镜子宫中隔切除术（TCRS）对子宫中隔合并不孕症及复发性流产患者的治疗效果。方法选择2010年7月-2015年4月山西现代妇产医院收治子宫中隔合并不孕症或复发性流产患者21例，住院行TCRS，术毕宫腔内放置球囊导尿管或宫内节育器拟预防宫腔粘连，定时宫腔镜检查，明确有无宫腔粘连。术后门诊及电话随访8-24个月，确定妊娠及分娩情况。结果TCRS后宫内放置球囊导尿管17例，术后1周宫腔镜检查8例，75．00％无宫腔粘连；术后1月宫腔镜检查5例，2例无宫腔粘连，2例见子宫内膜瘢痕，1例宫腔粘连；宫内放置节育器4例，75．00％无富腔粘连。术后随访17例，占80．95％，妊娠率为82．35％，足月分娩率为58．82％，中期妊娠2例，早期妊娠1例，稽留流产1例。结论对于子宫中隔合并不孕症及复发性流产的患者，TCRS安全有效，多可获得满意的妊娠结局。术后宫腔内放置球囊导尿管或宫内节育器预防宫腔粘连的效果及差异不明显。Objective To explore the curative effect of hysteroscopic transcervical resection of septa （TCRS） in treatment of patients with uterine septum combined with infertility and recurrent spontaneous abortion （RSA） . Methods Twenty-one patients with uterine sep- turn combined with infertility or RSA were selected from Shanxi Modem Obstetrics and Gynecology Hospital from July 2010 to April 2015, then hysteroscopic TCRS was performed after admission. A balloon catheter or intrauterine device （IUD） was applied within uterine cavity to prevent intrauterine adhesion after operation. Regular hysteroseopy was performed to confirm whether there was intrauterine adhesion. The patients were followed up for 8-24 months in Outpatient Department or by telephone after operation to confirm pregnancy and delivery situa- tions. Results Seventeen patients were treated by a balloon catheter within uterine cavity after hysteroscopic TCRS. Eight patients under- went hysteroscopic examination after one week of operation. Intrauterine adhesion was not found in 75.00% of the patients. Five patients un- derwent hysteroscopy after one month of operation, intrauterine adhesion was not found in two patients, endometrial sear was found in two pa- tients, intrauterine adhesion was found in one patient ; four patients were treated by IUD, intrauterine adhesion was not found in 75.00% of the patients. Seventeen patients were followed up after operation, accounting for 80. 95%, the pregnancy rate and full-term pregnancy rate were 82. 35% and 58. 82%, respectively, two pregnant women during the second trimester of pregnancy, one pregnant woman during the first trimester of pregnancy, and one case of missed abortion were included. Conclusion TCRS is safe and effective for thcpatients with u- terine septum combined with infertility and RSA, most of the patients can obtain satisfied pregnancy outcome. The effects and difference of applying balloon catheter or IUD within uterine cavity after hysteroscopic TCRS are not significant.

关 键 词：子宫中隔 不孕症 宫腔镜子宫中隔切除术 宫腔粘连 

分 类 号：R711.6[医药卫生—妇产科学]