宫腔镜子宫中隔切开术对不良孕产史不孕中隔子宫患者生殖预后改善疗效

摘要

目的：探讨宫腔镜子宫中隔切开术对有不良孕产史及不孕的中隔子宫患者生殖预后改善作用。方法2012年8月至2015年8月80例有不良孕产史以及不孕的中隔子宫患者，分为经宫颈宫腔镜下子宫中隔切开术组（切开术组，n=40）和经宫颈宫腔镜子宫中隔切除术组（切除术组，n=40）。给予切除术组患者经宫颈宫腔镜子宫中隔切除术治疗，给予切开术组患者经宫颈宫腔镜下子宫中隔切开术治疗，然后对两组患者的手术时间、术中出血量、膨宫液用量、术后宫腔镜复查情况及生殖预后进行统计分析。结果切开术组患者的手术时间显著短于切除术组（P<0.05），术中出血量、膨宫液用量均显著少于切除术组（P<0.05），术后残隔发生率2.5%显著低于切除术组17.5%（P<0.05），内膜上皮化满意度62.5%显著高于切除术组37.5%（P<0.05），术后妊娠率62.5%显著高于切除术组37.5%（P<0.05），妊娠状态中比例2.5%显著低于切除术组22.5%（P<0.05）。结论宫腔镜子宫中隔切开术较宫腔镜子宫中隔切除术更能有效改善有不良孕产史以及不孕的中隔子宫患者生殖预后。%Objective To investigate the hysteroscopic septum incision of adverse pregnancy history,and infertility uterus septus patients reproductive prognosis improvement. Methods From August August 2012 to 2015,80 patients with adverse pregnancy history,and infertility of uterine septum were divided into the cervical hysteroscopic uterine septum incision group(open surgery group,n=40)and transcervical hysteroscopic septum resection group(resection group,n=40)in the two groups. Cervical hysteroscopic septum resection was given to excision group patients, cervical hysteroscopic septum uterus incision surgery was given the incision group data such as operation time,blood loss,uterine distending medium dosage,hysteroscopic reexamination after and reproductive prognosis were recorded, compared and analyzed. Results the time of operation in the incision group of patients was significantly shorter than in the excision group(P<0.05),the blood loss,uterine distention fluid volume were significantly less than that of the resection group(P<0.05),postoperative residual vibration occurrence rate of 2.5% was significantly lower than that of the resection group 17.5%(P<0.05),endometrial epithelial satisfaction 62.5% was significantly higher than that of resection were 37.5%(P<0.05),postoperative pregnancy rate was 62.5% , which was significantly higher than that of resection were 37.5%(P<0.05),the pregnancy state ratio of 2.5% was significantly lower than that of the resection group(P< 0.05). Conclusion Hysteroscopic septum incision with hysteroscopic septum resection can effectively improve the adverse pregnancy and infertility of uterine septum in patients with reproductive outcomes.