论文部分内容阅读
目的:探讨宫腔镜子宫纵隔切除术治疗子宫中隔引起的复发性流产及不孕的临床效果。方法:将安阳市人民医院2009年10月~2012年11月收治的60例子宫中隔患者(病例组)分为不孕组(24例)和复发性流产组(36例),两组患者均进行宫腔镜子宫中隔切除术治疗并进行随访观察,观察并记录患者的妊娠率及分娩情况;随机选择同期正常分娩的800例正常子宫妇女(对照组)的妊娠及分娩结局进行对比分析。结果:不孕组与复发性流产组术后3个月出现首次受孕成功,6至12个月时受孕成功的高峰期。不孕组患者术后2年的妊娠率为66.67%,足月妊娠率为75.00%、活婴率87.50%均显著高于术前(P<0.05);自然流产率和早产率低于术前。复发性流产组患者术后2年的妊娠率低于术前2年(P<0.05),这是由于成功妊娠后流产率较术前显著降低所致(P<0.05),术后2年的足月妊娠率为82.05%、活婴率为84.62%,均显著高于术前(P<0.05)。病例组的臀位率、胎儿窘迫率与对照组比较差异不显著(P>0.05),但是早产率、胎膜早破率、剖宫产率、出生低体重率、围生儿死亡率均显著高于对照组(P<0.05)。结论:对于子宫中隔造成的不孕或复发性流产患者采用宫腔镜子宫中隔切除术能够取得很好的治疗效果,但分娩不良情况较正常子宫妊娠妇女略高,所以应该加强对该类患者分娩期、围生期监护和治疗。
Objective: To investigate the clinical effect of hysteroscopic uterine resection for recurrent miscarriage and infertility caused by uterine septum. Methods: Sixty cases of uterine septum (case group) admitted to Anyang People’s Hospital from October 2009 to November 2012 were divided into two groups: infertile group (24 cases) and recurrent spontaneous abortion group (36 cases) All patients underwent hysteroscopic resection of uterus resection and follow-up observation. The pregnancy rate and delivery status were observed and recorded. The pregnancy and delivery outcomes of 800 normal uterine women (control group) . Results: Infertility group and recurrent spontaneous abortion group had the first successful conception at 3 months and the peak of conception at 6 to 12 months after operation. The infertility group had 66.67% of pregnancy rate after 2 years, full-term pregnancy rate of 75.00%, and live birth rate of 87.50%, all of which were significantly higher than preoperative (P <0.05). The spontaneous abortion rate and preterm birth rate were lower than preoperative . The pregnancy rate in patients with recurrent spontaneous abortion after 2 years was lower than that before 2 years (P <0.05). This was due to the significant decrease in abortion rate after successful pregnancy (P <0.05), 2 years after operation Full-term pregnancy rate was 82.05%, live birth rate was 84.62%, were significantly higher than preoperative (P <0.05). The breech rate and fetal distress rate in case group were not significantly different from those in control group (P> 0.05), but the rates of premature delivery, premature rupture of membranes, cesarean section rate, low birth weight and perinatal mortality were all significant Higher than the control group (P <0.05). CONCLUSIONS: Hysteroscopic resection of hysteroscopic resection of the uterus caused by infertility or recurrent spontaneous abortion can achieve a good therapeutic effect, but the delivery of malnutrition is slightly higher than the normal uterine pregnancy women, it should be strengthened to this category Patients during childbirth, perinatal care and treatment.