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

发布时间：2018-05-29 02:00

本文选题：完全中隔子宫 + 双宫颈　；参考：《中国实用妇科与产科杂志》2015年02期

【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(P0.05);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。
[Abstract]:Objective to investigate the therapeutic effect of hysteroscopy on patients with complete septum uterus, double cervix and vaginal mediastinum. Methods from September 2004 to August 2013, 64 inpatients with complete septum uterus, double cervix and vaginal mediastinum were treated with hysteroscopic hysterectomy and vaginal mediastinectomy in Department of Obstetrics and Gynecology, Zhejiang University Medical College. Two groups were divided into recurrent abortion group (n = 26) and infertility group (n = 38). Results in the repeated abortion group, 25 cases were pregnant, the cumulative pregnancy was 31 times, the spontaneous abortion rate was decreased from 83.1% to 41.9% / 31%, the full-term rate, the premature rate and the live rate were 35.575 / 31 and 54.817 / 31, respectively, which were significantly different from those before operation (P0.050.031) and the infertility group (18 cases). The pregnancy rate was 47.4% 18 / 38, 12 of which were term delivery. There were 32 cases of preterm and full-term labor. The rate of premature delivery was 28. 1 / 32, and the full-term rate was 71. 9% / 32. The placenta adhesions, the incidence of implantation was 21.9%, the incidence of postpartum hemorrhage was 25.0% and 8 / 32%. Conclusion hysteroscopy can improve pregnancy rate and reproductive prognosis in patients with complete septum uterus, double cervix and vaginal mediastinum.
【作者单位】：浙江大学医学院附属妇产科医院;宁波市妇女儿童医院;
【基金】：2013年浙江省人口计生委立项课题(JSW2013-B011)
【分类号】：R713

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