中国实用妇科与产科杂志

中国实用妇科与产科杂志

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宫腔镜电切术治疗完全中隔子宫双宫颈阴道纵隔64例生殖预后分析

黄丽娜，江静逸，吴瑞瑾   

  1. 作者单位：浙江大学医学院附属妇产科医院（黄丽娜现工作于宁波市妇女儿童医院），浙江 杭州310006
  • 出版日期:2015-02-02 发布日期:2015-01-22
  • 通讯作者: 吴瑞瑾
  • 基金资助:

    2013年浙江省人口计生委立项课题（JSW2013-B011）

Analysis of reproductive prognosis in 64 cases of complete septate uterus with duplicated cervix and longitudinal vaginal septum after hysteroscopic septum resection.

HUANG Li-na**,JIANG Jing-yi,WU Rui-jin.   

  1. Women’s Hospital,School of Medicine,Zhejiang University（*Ningbo Women And Children’s Hospital）,Hangzhou 310006,China
  • Online:2015-02-02 Published:2015-01-22

摘要：

目的 探讨宫腔镜下子宫中隔电切除术对完全中隔子宫、双宫颈、阴道纵隔患者的治疗效果。方法 2004年9月至2013年8月浙江大学医学院附属妇产科医院完全中隔子宫、双宫颈、阴道纵隔住院患者64例，均行宫腔镜下子宫中隔电切除术及阴道纵隔切除术，分为反复流产组（26例）和不孕组（38例），电话或门诊随访妊娠结局。结果 反复流产组25例妊娠，累计妊娠31次，自然流产率由术前83.1%（54/65）下降为41.9%（13/31），足月产率、早产率和活产率分别为35.5%（11/31）、19.3 %（6/31）和54.8%（17/31），与术前比较差异均有统计学意义（P<0.05）；不孕组18例妊娠，妊娠率47.4%（18/38），其中12例足月分娩。研究对象中早产及足月产共32例，早产率28.1%（9/32），足月产率71.9%（23/32）。研究对象胎盘粘连、植入发生率21.9%（7/32），产后出血发生率25.0%（8/32）。结论 宫腔镜下子宫中隔电切除术可提高完全中隔子宫、双宫颈、阴道纵隔患者的妊娠率及生殖预后。

关键词: 完全中隔子宫, 双宫颈, 阴道纵隔, 宫腔镜电切除术, 生殖预后

Abstract:

Abstract： Objective To evaluate the reproductive prognosis of patients with duplicated cervix and longitudinal vaginal septum undergoing hysteroscopic septum resection of the complete septate uterus.Methods Sixty-four patients with complete septate uterus and duplicated cervix and longitudinal vaginal septum underwent hysteroscopic septum resection. All patients were divided into recurrent abortion group (n=26) and infertility group (n=38) according to their obstetrical situation. The pregnancy outcomes of these patients were followed up by telephone or out-patient clinic.Results In recurrent abortion group, there were 25 women with 31 pregnancies.The abortion rate declined from 83.1%(54/65）to 41.9% after operation（13/31）.The full-term pregnancy rate, premature delivery and living birth increased to 35.5%（11/31）,19.3 %（6/31）and 54.8%（17/31）respectively (P<0.05). In infertile group, there were 18 women pregnant (18/38),including 12 full-term labor. In the research objects,the cases of premature labor and full-term labor were 32 .The premature delivery rate was 28.1%（9/32）and the full-term pregnancy rate was 71.9%（23/32）.In the research objects,the incidence of placental adherence was 21.9%（7/32）,and the incidence of postpartum hemorrhage was 25.0%（8/32）. Conclusions The pregnancy rates and reproductive prognosis in the women with complete septate uterus and duplicated cervix and longitudinal vaginal septum is improved after hysteroscopic septum resection.

Key words: complete septate uterus, duplicated cervix, longitudinal vaginal septum, hysteroscopic septum resection, reproductive prognosis

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