宫腔镜电切术治疗子宫中隔不孕的疗效研究

The research of curative effect of hysteroscope electrotomy for treating infertile women with uterine septum

目的:研究宫腔镜下子宫中隔切除术对不孕不育患者的疗效。方法:选取医院收治的64例子宫中隔患者,按照手术方法的不同,将其分为观察组(25例)和对照组(39例)。观察组采用宫腔镜+腹腔镜联合治疗;对照组采用单纯行宫腔镜电切术;观察对比两种术式对患者妊娠结局的影响。结果:在22例完全子宫中隔患者中,术后妊娠率为59.09%,高于术前的18.18%(x^2=4.539,P<0.05);术后足月顺产率为31.82%,显著高于术前的0%(x^2=8.324,P<0.05)。42例不完全子宫中隔患者中,术后的妊娠率为73.81%,高于术前的33.33%(x^2=13.832,P<0.05);术后的足月顺产率为54.76%,高于术前的0%(x^2=31.672,P<0.05)。结论:宫腔镜下子宫中隔切除术对不孕不育患者疗效显著,具备创伤小、出血少、预后快等微创手术优点,值得在临床中推广。

Objective：To study the effect of hysteroscope electrotomy for treating infertile women with uterine septum.Methods： 64 patients with uterine septum were divided into observation group （25cases） and control group （39cases） according to different operation method. Patients of observation group received the combination mode of hysteroscope and laparoscope while the patients of control group received hysteroscope electrotomy. And then the effects of the two surgical methods for pregnancy outcome of the patients of the two groups were compared. Results： In 22 patients with complete uterine septum, the postoperative pregnancy rate was 59.09% which was significantly higher than preoperative pregnancy rate （18.18%） （x2=4.539,P＆lt;0.05）. The postoperative rate of normal childbirth in term was 31.82% which was significantly higher than preoperative outcome （0%） （x2=8.324, P〈0.004）. In 42 patients which incomplete uterine septum, the postoperative pregnancy rate was 73.81% which was significantly higher than preoperative pregnancy rate （33.33%） （x2=13,832,P〈0.05）. The postoperative rate of normal childbirth in term was 54.76% which was significantly higher than preoperative outcome （0%）（x2=31.672, P〈0.004）.Conclusion： Hysteroscope electrotomy is significant in the treatment for patient with uterine septum, and it has series of advantages of minimally invasive surgery including small wound, less blooding, fast prognosis and others. Therefore, it is worthy in the clinical promoting.