宫腔镜治疗子宫纵膈的临床分析

Clinical Analysis of Hysteroscope in the Treatment of Intrauterine Septa

目的探讨宫腔镜下子宫纵膈电切术后患者的妊娠结局。方法回顾性分析我院2006年12月至2010年6月36例子宫纵膈患者行腹腔镜监视下宫腔镜下子宫纵隔电切术后复查宫腔镜了解宫腔恢复情况并随访其妊娠情况。结果 36例子宫纵隔患者全部一次完成手术,无一例发生并发症,术后3个月B超复查,宫腔形态正常。36例随访9～42个月,受孕29例,受孕率80.6%(29/36),妊娠距手术时间5～12个月;3例流产,流产率10.3%(3/29);足月分娩20例,臀位5例,8例发生胎膜早破,发生率为40%(8/20)。所有成功分娩的患者无胎儿畸形、低出生体重儿的发生。结论宫腔镜下子宫纵膈电切术是治疗子宫纵隔的理想方法,能有效地改善妊娠结局。

Objective To explore the pregnancy outcomes of patients after hysteroscope electrotomy for intrauterine septum.Methods 36 patients with hysteroscope electrotomy for intrauterine septum monitored by laparoscope were retrospectively analysed for the uterine recovery by hysteroscopic reexamination and the pregnancy outcomes were followed up.Results 36 patients with intrauterine septum in our hospital from 2006 to 2010 were performed the surgery only once with no case of complications;the B ultrasound reexamination showed the Normal form of uterine cavity 3 month after operation.All 36 cases were followed-up for 9 to 42 months;29 cases were pregnant with the pregnancy rate of 80.6%（29/36）;the time of pregnancy were 5 to 12 months after operation;3 cases had abortion with the abortion rate of 10.3%（3/29）;20 cases had full-term delivery;5 cases were breech presentation;8 cases had premature rupture of membranes with the incidence of 40%（8/20）.All cases with successful delivery had no fetal anomaly or low birth weight infants.Conclusions Hysteroscope electrotomy is an ideal method for intrauterine septum,which can effectively improve the pregnancy outcomes.