Abstract:

Objective: To investigate the effect of postoperative with /without adjuvant therapy on reproductive outcome after transcervical resection of septa (TCRS). Methods: 195 out of 216 cases who were performed TCRS were followed up. They were divided into three groups postoperatively:60 cases who were no adjuvant treatment (group1)，33cases who were artificial cyclical treatment(group2) and 102 cases who were artificial cyclical treatment combining with intrauterine device (IUD)(group3). 195 patients were followed up for 20 to 44 months. The rates of spontaneous abortion, premature birth, fetal death and term delivery were recorded. Results: The rates of spontaneous abortion, premature birth, fetal death and term delivery were 28.57%, 2.86%, 2.86% and 60.00% in group 1;14.29%, 5.71%, 0 and 65.71% in group 2; 27.27%, 6.49%, 0 and 48.05% in group 3, respectively. There were no significant difference among three groups in the rates of spontaneous abortion, premature birth, fetal death and term delivery. Conclusion: The effect of postoperative with /without adjuvant treatment on reproductive outcome after TCRS has no significant difference.

Key words: hysteroscopy, uterine septum, metroplasty, intrauterine device, estrogen, pregnancy

摘要：

目的：探讨宫腔镜子宫中隔切除术(TCRS)后辅助治疗对妊娠结局的影响。方法：收集2007年1月至2008年12月首都医科大学附属复兴医院行TCRS 的患者共216例，随访到195例。术后患者分为无辅助治疗组(60例，术后无辅助治疗)、人工周期组(33例，术后予人工周期3个月)、人工周期+宫内节育器(IUD)组(102例，术后予人工周期3个月同时放置IUD 3个月)。随访20～44个月，随访内容为3组患者的自然流产、早产、胎死宫内和足月分娩情况。结果：3组术后自然流产率、早产率、胎死宫内率和足月分娩率分别为无辅助治疗组28.57%、2.86%、2.86%和60.00%;人工周期组14.29%、5.71%、0和65.71%;人工周期+IUD组27.27%、6.49%、0和48.05%。3组差异无统计学意义(P>0.05)。结论：TCRS术后传统的辅助治疗(人工周期;人工周期+IUD)与无辅助治疗相比，在改善妊娠结局方面差异不大。

关键词: 宫腔镜, 子宫中隔, 矫形, 宫内节育器, 雌激素, 妊娠