宫腔镜下改良子宫纵隔切除术治疗流产20例临床分析

Clinical analysis on 20 cases with abortion treated with modified hysteroscopic uterine septum resection

目的:探讨宫腔镜下改良子宫纵隔切除术治疗子宫纵隔流产的疗效。方法:将40例因子宫纵隔导致流产的患者分为宫腔镜手术组(治疗组)与药物治疗组(对照组),每组20例,治疗组行改良宫腔镜下子宫纵隔切除手术,对照组自然观察妊娠及妊娠后加以药物安胎治疗。结果:治疗组经改良子宫纵隔切除术后,其中19例术后1年内妊娠,受孕率达95%,18例妊娠至足月分娩,成功率达90%,其中1例于孕早期出现流产症状而终止妊娠;对照组自然妊娠17例,受孕率达85%,2例妊娠至足月分娩,成功率为10%,其中15例于早期或中期妊娠期间出现流产症状而终止妊娠,失败率达88%。两组受孕率比较无统计学差异(P>0.05),但妊娠成功率比较差异具有统计学意义(P<0.01)。结论:对因子宫纵隔导致流产的患者,宫腔镜下改良子宫纵隔切除术在术后提高妊娠率及降低流产率方面有明显的疗效。

Objective： To explore the therapeutic effect of modified hysteroscopic uterine septum resection in treatment of uterine septum induced abortion. Methods： 40 patients with uterine septum induced abortion were divided into hysteroscopic surgery group （ treatment group） and drug treatment group （ control group） ,20 patients in each group,the patients in treatment group underwent modified hyste-roscopic uterine septum resection,and the patients in control group were observed naturally and treated with antiabortifacient. Results： In treatment group,19 patients got pregnancy within one year after surgery,the pregnancy rate was 95% ; 18 patients were full-term birth,the success rate was 90% ,one patient terminated pregnancy because of miscarriage in early pregnancy. In control group,17 patients got preg- nancy,the pregnancy rate was 85% ,2 patients were full-term birth,the success rate was 10% ,15 patients terminated pregnancy because of miscarriage in early and middle pregnancy,the failure rate was 88%. There was no significant difference in pregnancy rate between the two groups （ P 0. 05） ,but there was significant difference in pregnancy success rate between the two groups （ P 0. 01） . Conclusion： For the patients with uterine septum induced abortion,modified hysteroscopic uterine septum resection has obvious therapeutic effect in improving pregnancy rate and reducing abortion rate.