宫腔镜下子宫纵隔切除术后不同预防方法对宫腔粘连及妊娠结局的影响

Effects of Different Preventive Methods after Uterus Septum Resection Under Hysteroscope on Intrauterine Adhesion and Pregnancy Outcome

目的:探讨宫腔镜下子宫纵隔切除术后不同预防宫腔粘连方法对患者术后宫腔粘连及妊娠结局的影响。方法:选取符合标准的患者90例随机分为A、B、C三组,均行宫腔镜下子宫纵隔切除术,术后A组采用雌激素预防宫腔粘连、B组放置带铜圆形宫内节育器、C组不采取任何干预措施。结果:三组患者宫腔深度、纵隔长度与宫深关系、纵隔基底宽度相似,差异均无统计学意义(P>0.05)。术后3个月行宫腔镜检查,三组患者残余中隔发生率及术后宫腔粘连发生率比较,差异无统计学意义(P>0.05)。术后随访2年,三组患者妊娠率、自然流产率及术后首次妊娠时间比较,差异无统计学意义(P>0.05)。结论:宫腔镜下子宫纵隔切除术治疗子宫纵隔安全、有效,改善患者孕产结局;术后应用雌激素或宫内节育器对防止宫腔粘连形成、提高妊娠率及改善妊娠结局无明显益处。

To investigate the effects of different preventive methods after uterus septum re-section under hysteroscope on postoperative intrauterine adhesion and pregnancy outcome in the patients . Method：90 eligible patients were selected and randomly divided into group A , group B and group C .All the patients underwent uterus septum resection under hysteroscope;after the surgery , group A used estrin to pre-vent from intrauterine adhesion , group B used round intrauterine devices with copper , and group C did not take any intervention measure .Result：The depths of uterine cavity , septum lengths , relationships between the depth of uterine cavity and septum length and septum fundus widths of the patients of the three groups were similar, and the differences were statistically insignificant （P〉0.05）.3 months after the surgery, hyste-roscopy was conducted , and the differences in incidence of residual septum and incidence of postoperative in-trauterine adhesion among the patients of the three groups were statistically insignificant （P〉0.05）.The pa-tients were followed up for 2 years after the surgery , and the differences in pregnancy rate , spontaneous abor-tion rate and postoperative primipara time among the patients of the three groups were statistically insignifi-cant （ P〉0.05） .Conclusion：Uterus septum resection under hysteroscope is safe and effective , and can im-prove the pregnancy outcome of the patients;postoperative use of estrin or intrauterine device has insignifi-cant benefit to preventing from intrauterine adhesion , elevating pregnancy rate and improving pregnancy out-come.