不同治疗方案治疗子宫瘢痕憩室反复宫腔积液不孕的效果  

Effect of Different Treatment Regimens on Infertility Caused by Recurrent Uterine Effusion in Uterine Cicatrix Diverticulum

作　　者：洪婧贞 江帆 李华芳 HONG Jingzhen;JIANG Fan;LI Huafang(Department of Reproductive Medicine,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou Fujian 363000,China;Department of Reproductive Surgery,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou Fujian 363000,China)

机构地区：[1]福建医科大学附属漳州市医院生殖医学科,福建漳州363000 [2]福建医科大学附属漳州市医院生殖外科,福建漳州363000

出　　处：《中国卫生标准管理》2023年第20期15-18,共4页China Health Standard Management

摘　　要：目的探讨剖宫产后子宫瘢痕憩室反复宫腔积液不孕患者的最佳治疗方案。方法将2019年1月—2022年1月在福建医科大学附属漳州市医院就诊的102例剖宫产术后子宫瘢痕憩室反复宫腔积液患者作为研究对象,按随机数字表法将其分为观察组和对照组,各51例。观察组采用宫腔镜下瘢痕憩室开渠术治疗,对照组采用保守治疗。比较两组患者排卵后内膜厚度、宫腔积液、妊娠结局(妊娠率、流产率)。结果观察组治疗后1年内有41例成功妊娠,临床妊娠率为80.39%,2例流产,流产率为4.88%;对照组治疗后1年内有22例成功妊娠,临床妊娠率为43.14%,2例流产,流产率为9.09%;观察组临床妊娠率显著高于对照组(P<0.05),流产率与对照组比较,差异无统计学意义(P>0.05)。观察组宫腔积液量明显低于对照组(P<0.05);两组排卵后内膜厚度比较,差异无统计学意义(P>0.05)。结论宫腔镜下瘢痕憩室开渠术可以提高子宫瘢痕憩室反复宫腔积液患者妊娠率。Objective To explore the best treatment for infertility patients with uterine scar diverticulum repeated intrauterine effusion after cesarean section.Methods A total of 102 patients with recurrent intrauterine effusion of cicatricial diverticulum after caesarean section who were treated in Zhangzhou Affiliated Hospital of Fujian Medical University from January 2019 to January 2022 were taken as the research object.They were randomly divided into the observation group and the control group according to the number,with 51 cases in each group.The observation group was treated with hysteroscopic canalization of cicatricial diverticulum,and the control group was treated with conservative management.The endometrial thickness,intrauterine effusion,and pregnancy outcome(pregnancy rate,abortion rate)of patients in the two groups after ovulation were compared.Results Within one year after treatment,41 cases of successful pregnancy were observed in the observation group,with a clinical pregnancy rate of 80.39%,2 cases of miscarriage,and a miscarriage rate of 4.88%.Within one year after treatment,22 cases of successful pregnancy were observed in the control group,with a clinical pregnancy rate of 43.14%,and 2 cases of miscarriage,with a miscarriage rate of 9.09%.The clinical pregnancy rate in the observation group was significantly higher than that in the control group(P<0.05),and there was no statistically significant difference in the miscarriage rate compared to the control group(P>0.05).The amount of uterine cavity effusion in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in endometrial thickness between the two groups after ovulation(P>0.05).Conclusion Hysteroscopic scarring diverticulostomy can improve the pregnancy rate of patients with recurrent intrauterine fluid accumulation in the uterine scar diverticulum.

关 键 词：宫腔镜下瘢痕憩室开渠术 保守治疗 剖宫产 子宫瘢痕憩室 反复宫腔积液 妊娠结局 

分 类 号：R711[医药卫生—妇产科学]