论文部分内容阅读
目的评价宫腔镜联合B超治疗宫腔粘连的安全性和有效性,以及对因宫腔粘连所致不孕患者的妊娠率的改善情况。方法回顾性分析2006年12月—2009年12月在襄樊市中心医院行B超监测下行宫腔镜宫腔粘连切除术(transcervical resection of adhesions,TCRA)的86例因宫腔粘连所致不孕患者的临床资料。结果在B超监测下宫腔镜治疗宫腔粘连的86例患者中,无并发症发生。术后受孕率达58.1%,足月分娩率达70.00%。受孕率高低与以下有关:①宫腔粘连程度轻度粘连者妊娠率最高92.6%(25/27);中度粘连者妊娠率50%(22/44);重度粘连者妊娠率最低2%(3/5),P(0.05,差异有统计学意义。②宫腔粘连类型中央型粘连妊娠率最高90.9%(30/33);周围型与混合型粘连妊娠率无明显差异,分别为39%(16/41)、33.3%(4/12)。③术后处理,宫腔放置气囊尿管者,术后再次粘连发生率低于宫腔放置节育环者,受孕率均高于宫腔放置节育环者,差异有统计学意义。宫腔粘连程度与宫腔操作次数无明显关系,与感染及宫腔操作不当有明显关系。结论宫腔镜联合B超是一种治疗宫腔粘连微创有效的方法,能有效提高因宫腔粘连所致不孕患者的妊娠率。
Objective To evaluate the safety and efficacy of hysteroscopy combined with B-ultrasound in the treatment of intrauterine adhesions and to improve the pregnancy rate of patients with infertility due to intrauterine adhesions. Methods Retrospective analysis of 86 cases of infertility caused by intrauterine adhesions in December 2006 -2009 in December in Hospitals of Xiangfan Central Hospital under ultrasound monitoring of hysteroscopic hysteroscopic resection of adhesions (transcervical resection of adhesions, TCRA) The patient’s clinical data. Results In the 86 cases of intrauterine adhesions treated by hysteroscopy under B-ultrasound, no complication occurred. Postoperative pregnancy rate of 58.1%, full-term delivery rate of 70.00%. The rate of conception was related to the following: ① The pregnancy rate of the patients with mild adhesion of uterine cavity was 92.6% (25/27), that of moderate adhesion was 50% (22/44), and that of patients with severe adhesion was 2% 3/5), P (0.05, the difference was statistically significant.②The rate of central adhesions in uterine cavity adhesions was the highest (90.9%, 30/33), there was no significant difference in the rate of peripheral and mixed adhesions (39% (16/41), 33.3% (4/12) .③Postoperatively, the balloon catheter was placed in the uterine cavity, and the incidence of re-adhesions was lower than that of the IUD in the uterine cavity IUD, the difference was statistically significant.The degree of uterine adhesions and the number of intrauterine operation has no significant relationship with infection and improper uterine operation has a significant relationship.Conclusion Hysteroscopy combined with B-type is a treatment of uterine adhesions minimally invasive Effective method, can effectively improve the pregnancy rate of infertility patients due to intrauterine adhesions.