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目的分析宫腔镜子宫肌瘤电切术(TCRM)治疗子宫肌瘤伴不孕患者的妊娠结局,为制定最佳手术方案提供参考。方法 86例采用腹腔镜子宫肌瘤剔除术(TLM)的患者作为TLM组,72例采用TCRM治疗为主的子宫肌瘤伴不孕患者,设为TCRM+TLM组,所有患者均随访6~36个月,观察两组患者术后妊娠率、手术前后自然流产率。结果手术前两组累计妊娠次数与自然流产率比较,差异无统计学意义(P>0.05)。手术前后各组自然流产率比较,差异具有统计学意义(P<0.05)。TCRM+TLM组术后妊娠率明显高于TLM组,差异具有统计学意义(P<0.05);自然流产率两组比较,差异无统计学意义(P>0.05)。结论 TCRM治疗子宫肌瘤伴不孕对子宫的损伤较小,可明显增加妊娠率,降低自然流产率,与TLM共同进行可同时对盆腔情况予评估及治疗,明显优于单纯TLM治疗。
Objective To analyze the pregnancy outcome of hysteroscopic uterine fibroids resection (TCRM) for the treatment of uterine leiomyoma with infertility and to provide a reference for the development of the optimal surgical plan. Methods Totally 86 patients with TLM were treated with TLM and 72 patients with uterine leiomyoma and infertility treated with TCRM were selected as TCRM + TLM group. All patients were followed up for 6 to 36 Month, observe the two groups of patients after pregnancy rate, spontaneous abortion rate before and after surgery. Results The cumulative number of pregnancies before pregnancy and spontaneous abortion, the difference was not statistically significant (P> 0.05). The difference of spontaneous abortion rate between the two groups before and after surgery was statistically significant (P <0.05). The pregnancy rate in TCRM + TLM group was significantly higher than that in TLM group, the difference was statistically significant (P <0.05). There was no significant difference in spontaneous abortion rate between the two groups (P> 0.05). Conclusion TCRM treatment of uterine fibroids with infertility less damage to the uterus, can significantly increase the pregnancy rate and reduce the spontaneous abortion rate, with the TLM can simultaneously pelvic assessment and treatment, significantly better than pure TLM treatment.