摘要
目的:探讨宫腔镜下子宫中隔切除术(TCRS)后放置宫内节育器(IUD)和(或)激素补充治疗(HRT)对中隔子宫患者妊娠和妊娠结局的影响。方法:对行B超监测下或腹腔镜下行TCRS并有生育要求和随访资料完整的113例患者的临床资料进行回顾性分析,对患者在术后采用不同的方法的妊娠情况进行比较,其中术后放置IUD及应用HRT治疗38例(IUD+HRT组),术后仅放置IUD 18例(单纯IUD组),术后仅应用HRT 22例(单纯HRT组)和仅单纯手术治疗35例(单纯手术组)。结果:113例患者的自然流产率由术前的88.75%下降至术后的20.39%,活产率由术前4.38%上升至术后73.79%,差异有统计学意义(χ2=1.243,P=0.000;χ2=1.398,P=0.000)。4组患者在妊娠率、自然流产率、活产率及妊娠距手术时间的比较,差异均无统计学意义(P>0.05);IUD+HRT组自然流产率(9.09%)低于单纯手术组患者(33.33%),但差异无统计学意义(χ2分割检验,P>0.009)。结论:TCRS治疗中隔子宫是一种简单、安全、有效的方法,但术后放置IUD和(或)HRT治疗对改善TCRS术后患者妊娠结局的疗效尚不确切。
Objective:To investgate the efficacy of intrauterine device(IUD) and hormone replacement therapy(HRT) after the transcervical resection of septa in women with septate uterus, Methods:113 patients with septate uterus and bearing requirement and a complete follow-up data were included, all of them re- ceived the treatment of TCRS:after surgery,38 patients received IUD +HRT( IUD +HRT group) ,18 patients received IUD only( IUD group) ,22 patients received HRT only ( HRT group), and 35 patients received no postoperative treatment( surgery group), respectively. The clinical data of the patients were respectively ana- lyzed. Results:Miscarriage rates of patients with septate uterus were significantly decreased from 88.75% before the surgery to 20.39% after surgery(X2 = 1. 243, P = 0. 000), and live birth rates were increased from 4.38% before the surgery to 73.79% after surgery ( X2 = 1. 398, P = 0. 000), but no significant difference: was found in miscarriage rates,live birth rates or the duration of pregnancy from the operation among patients ~ with IUD + HRT, IUD only, HRT only and no postoperative treatment ( P 〉 0. 05). Although the miscarriage rate of patients with IUD and HRT(9.09%) was lower than that of patients without postoperative treatment (33. 33%) ,there was no significant difference between them. Conclusions :TCRS is a safe, simple and ef- fective treatment for patients with uterine septum, but the efficacy of the postoperative treatment including IUD and HRT remains unclear.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2013年第10期769-772,共4页
Journal of Practical Obstetrics and Gynecology
关键词
中隔子宫
子宫中隔切除术
宫腔镜
宫内节育器
激素补充治疗
Septate uteru
Transcervical resection of septa
Hysteroscope
Intrauter'ine device
Hormonereplacement therapy ~