宫腔镜子宫纵隔电切术对女性妊娠结局的影响

Effect of uterine mediastinum hysteroscopic surgery on pregnancy outcomes for women

目的探讨宫腔镜电切治疗子宫纵隔对妊娠情况、妊娠结局的影响。方法选择郑州市妇幼保健院2004年2月至2012年6月宫腔镜确诊为子宫纵隔有生育要求的103例患者，观察组（53例）进行B超下或腹腔镜下宫腔镜纵隔电切术治疗，对照组（50例）患者自愿未进行治疗，对两组妊娠情况、妊娠结局进行回顾性分析。结果观察组患者的妊娠率较对照组明显增加，且流产率、早产率、不孕率均明显降低，两组比较差异有统计学意义（P〈0．05）；观察组中不全子宫纵隔电切术后妊娠率较完全子宫纵隔电切术后妊娠率明显增高，但早产率、流产率及不孕率明显降低，两组比较差异有统计学意义（P〈0．05）；对照组中完全子宫纵隔与不全子宫纵隔对妊娠率及早产率的影响差异无统计学意义（P〉0．05）；完全子宫纵隔的流产率及不孕率较不全子宫纵隔增加，两组比较差异有统计学意义（P〈0．05）。结论宫腔镜电切子宫纵隔能有效的提高妊娠成功率，改善妊娠结局，是值得推广的一种安全有效的治疗方法。

Objective To investigate the effect of hysteroscopic treatment of uterine mediastinum on women＇ s pregnancy outcome. Methods One hundred and three patients with uterus mediastinum who were diagnosed by hysteroscopy from February 2004 to June 2012 were selected. Fifty-three patients in observation group were treated by hysteroscopic mediastinum electricity cut under ultrasound or laparoscopy, fifty patients in control group were not given treatment. The pregnancies and pregnancy outcomes of the two groups were retrospectively analyzed. Results The pregnancy rate in observation group was much higher than that in control group. The rate of abortion, preterm birth and infertility were significantly lower than those in the control group, the differences were significant between the two groups （ P 〈 0. 05 ）. The pregnancy rate of patients with insufficiency mediastinal was higher than that of patients with completely mediastinum during the observation group after receiving hysteroscopic electrical cutting treatment. The rate of abortion, preterm birth and infertility of patients with insufficiency mediastinal was significantly lower than that of patients with completely mediastinum after receiving the treatment, the difference was significant between the two groups （P 〈 0. 05 ）. In the control group, there were no significant differences between the insufficiency mediastinal and the completely mediastinum in the rates of pregnancy and preterm birth （ P 〉 0. 05 ）. But the rate of abortion and infertility of patients with insufficiency mediastinum was significantly lower than that of patients with completely mediastinum, the difference was significant between the two groups （P 〈 0. 05 ）. Conclusions The treatment of hysteroscopic electrical cutting uterine mediastinum can effectively improve the pregnancy rate and pregnancy outcomes, it is a safe and effective method and worth promoting.