目的回顾性分析宫腔镜下子宫纵隔切除术(tanscervical resection of septum,TCRS)后不同孕产史或不同纵隔类型患者的妊娠结局。方法选取2018年1月至2021年1月因子宫纵隔于郑州大学第三附属医院就诊并行宫腔镜下TCRS的145例患者为研究对...目的回顾性分析宫腔镜下子宫纵隔切除术(tanscervical resection of septum,TCRS)后不同孕产史或不同纵隔类型患者的妊娠结局。方法选取2018年1月至2021年1月因子宫纵隔于郑州大学第三附属医院就诊并行宫腔镜下TCRS的145例患者为研究对象,术后随访3~24个月,观察其手术效果及妊娠情况。结果术后共119例(82.07%)患者获得妊娠,总计妊娠次数为132次,与术前相比,术后获得妊娠人数与活产人数增加,累计妊娠次数与流产次数降低(P<0.05)。不孕组患者术后25例(65.79%)获得妊娠,但仍有13例(34.21%)不孕,与术前相比差异具有统计学意义(P<0.01);既往妊娠组及复发性流产组患者术后流产率下降,活产率提高(P<0.05)。完全子宫纵隔患者术前较不全子宫纵隔患者更易发生不孕(P<0.001),术后完全子宫纵隔组及不全子宫纵隔组较术前,流产率下降,活产率提升,差异具有统计学意义(P<0.001)。Logistic回归分析结果显示,年龄是导致术后继发性不孕症的独立危险因素[OR=4.796,95%CI(1.916,12.007),P<0.001]。结论宫腔镜下TCRS是一种安全、微创且能改善妊娠结局的手术方式,对于有生育要求的子宫纵隔患者可行TCRS以提高妊娠率及活产率。展开更多
Objective: To determine if sectioning of the cervical septum in hysteroscopic metroplasty of the complete uterine septum is associated with intraoperative bleeding, cervical incompetence, and secondary infertility. De...Objective: To determine if sectioning of the cervical septum in hysteroscopic metroplasty of the complete uterine septum is associated with intraoperative bleeding, cervical incompetence, and secondary infertility. Design: Multicenter, randomized, controlled clinical trial. Setting: University hospitals. Patient(s): Twenty-eight women with a diagnosis of complete uterine septum who had a history of pregnancy wastage or infertility. They were randomized into two groups: group A underwent metroplasty including section of the cervical septum; group B underwent the same procedure with preservation of the cervical septum. Intervention(s): Hysteroscopic metroplasty was performed for all patients in the two groups. Main Outcome Measure(s): Operating time, distending media deficit, total distending media used, intraoperative bleeding, complications, and reproductive outcome. Result(s): Operating times were 36.40 ± 10.67 minutes and 73 ± 14.40 minutes in group A and group B, respectively. Distending media deficit was 456.66 ± 165.68m Lin group A,while in groupB it was 673.84± 220.36. Two cases of pulmonary edema and three cases of significant bleeding ( > 150 mL)were seen in group B. The cesarean section rate was significantly higher in group B. There were no signifi cant differences in the reproductive outcome in the two groups. Conclusion(s): Resection of the cervical septum during hysteroscopic metroplasty of complete uterine septum makes the procedure safer, easier, and less complicated than the procedure with preservation of the cervical septum. This procedure is recommended for all cases of complete uterine septum.展开更多
文摘目的回顾性分析宫腔镜下子宫纵隔切除术(tanscervical resection of septum,TCRS)后不同孕产史或不同纵隔类型患者的妊娠结局。方法选取2018年1月至2021年1月因子宫纵隔于郑州大学第三附属医院就诊并行宫腔镜下TCRS的145例患者为研究对象,术后随访3~24个月,观察其手术效果及妊娠情况。结果术后共119例(82.07%)患者获得妊娠,总计妊娠次数为132次,与术前相比,术后获得妊娠人数与活产人数增加,累计妊娠次数与流产次数降低(P<0.05)。不孕组患者术后25例(65.79%)获得妊娠,但仍有13例(34.21%)不孕,与术前相比差异具有统计学意义(P<0.01);既往妊娠组及复发性流产组患者术后流产率下降,活产率提高(P<0.05)。完全子宫纵隔患者术前较不全子宫纵隔患者更易发生不孕(P<0.001),术后完全子宫纵隔组及不全子宫纵隔组较术前,流产率下降,活产率提升,差异具有统计学意义(P<0.001)。Logistic回归分析结果显示,年龄是导致术后继发性不孕症的独立危险因素[OR=4.796,95%CI(1.916,12.007),P<0.001]。结论宫腔镜下TCRS是一种安全、微创且能改善妊娠结局的手术方式,对于有生育要求的子宫纵隔患者可行TCRS以提高妊娠率及活产率。
文摘Objective: To determine if sectioning of the cervical septum in hysteroscopic metroplasty of the complete uterine septum is associated with intraoperative bleeding, cervical incompetence, and secondary infertility. Design: Multicenter, randomized, controlled clinical trial. Setting: University hospitals. Patient(s): Twenty-eight women with a diagnosis of complete uterine septum who had a history of pregnancy wastage or infertility. They were randomized into two groups: group A underwent metroplasty including section of the cervical septum; group B underwent the same procedure with preservation of the cervical septum. Intervention(s): Hysteroscopic metroplasty was performed for all patients in the two groups. Main Outcome Measure(s): Operating time, distending media deficit, total distending media used, intraoperative bleeding, complications, and reproductive outcome. Result(s): Operating times were 36.40 ± 10.67 minutes and 73 ± 14.40 minutes in group A and group B, respectively. Distending media deficit was 456.66 ± 165.68m Lin group A,while in groupB it was 673.84± 220.36. Two cases of pulmonary edema and three cases of significant bleeding ( > 150 mL)were seen in group B. The cesarean section rate was significantly higher in group B. There were no signifi cant differences in the reproductive outcome in the two groups. Conclusion(s): Resection of the cervical septum during hysteroscopic metroplasty of complete uterine septum makes the procedure safer, easier, and less complicated than the procedure with preservation of the cervical septum. This procedure is recommended for all cases of complete uterine septum.
