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目的:探讨宫腔镜子宫纵隔切除术后患者的生殖预后。方法:回顾性分析53例宫腔镜下电切术患者(其中因不孕就诊者32例,因自然流产就诊者21例),以宫腔镜联合腹腔镜诊断结果为标准,比较HSG及超声检查对子宫纵隔的诊断结果,随访患者的术后情况及妊娠情况,比较因不孕原因就诊者与因自然流产就诊者的妊娠率和足月产率。结果:31例患者在术后3～12月妊娠,总体妊娠率为62.1%,足月产率为77.8%。自然流产与足月产两组的妊娠率分别为78.6%和46.7%,足月产率分别为81.8%和71.4%,两组均无统计学差异。自然流产组的流产率由术前的81.1%降至术后的20.00%,足月产率由2.7%升至80.00%,差异有统计学意义。结论:超声对纵隔子宫的诊断优于HSG。宫腔镜下子宫纵隔切除术可改善妊娠结局,是一种安全有效的治疗手段。
Objective: To investigate the reproductive prognosis of patients after hysteroscopic uterine resection of mediastinum. Methods: A retrospective analysis of 53 cases of hysteroscopic resection patients (including 32 cases of infertility patients due to spontaneous abortion treatment of 21 cases), hysteroscopy combined with laparoscopic diagnostic results as a standard, compared HSG and ultrasound Check the diagnostic results of the uterine mediastinum, follow-up of patients after surgery and pregnancy, compared with infertility patients due to treatment of patients with spontaneous abortion and full-term pregnancy rate. Results: 31 cases of pregnancy in 3 to 12 months after pregnancy, the overall pregnancy rate was 62.1%, full-term monthly rate of 77.8%. The pregnancy rates of spontaneous abortion and full-term birth were 78.6% and 46.7% respectively, and the full-term birth rates were 81.8% and 71.4% respectively, with no significant difference between the two groups. Abortion rate in spontaneous abortion group decreased from 81.1% preoperatively to 20.00% postoperatively, while full-term birth rate increased from 2.7% to 80.00%. The difference was statistically significant. Conclusion: Ultrasound diagnosis of mediastinal uterus is better than HSG. Hysteroscopic resection of the uterus can improve pregnancy outcome, is a safe and effective treatment.