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目的比较宫腔镜下子宫中隔切除术后不同处理方法对妊娠结局的影响。方法选择子宫中隔病例96例,按照随机分组原则将其分成I、Ⅱ、Ⅲ3组,所有病例均行宫腔镜下子宫中隔切除术,术后Ⅰ组给予雌激素(戊酸雌二醇+甲羟孕酮)防止宫腔粘连发生,Ⅱ组宫腔放置含铜宫内节育器,Ⅲ组术后不予任何处理措施,经上述处理措施后,3月后行宫腔镜检查比较宫腔粘连情况,在2年随访期内比较宫内妊娠情况。结果术前3组宫腔深度、纵隔长度与宫深关系及纵隔基底宽度均无统计学差异(P>0.05)。术后3月再次行宫腔镜检查,残余中隔的发生率、术后宫腔粘连比较,3组患者不具有统计学差异(P>0.05)。在术后2年的随访期内,妊娠情况、自然流产情况、术后首次妊娠时间等3方面,3组比较不具有统计学差异(P>0.05)。结论宫腔镜下子宫中隔切除术对于子宫中隔的临床疗效显著,具有良好的妊娠结局,不同的术后处理方法 (雌激素、宫内节育器等)并不能改善临床疗效及妊娠结局。
Objective To compare the effect of different treatment methods after hysterectomy on the outcome of pregnancy. Methods A total of 96 cases of uterine septum were selected and divided into groups I, II and III3 according to the principle of randomization. All patients underwent hysteroscopic resection of uterine septum. Group I received estrogen (estradiol valerate + Medroxyprogesterone) to prevent the occurrence of intrauterine adhesions, Ⅱ intrauterine placement of copper-containing intrauterine device, Ⅲ group without any treatment after surgery, after the above measures, 3 months after hysteroscopy compared intrauterine adhesions Situation, in the 2-year follow-up comparison of intrauterine pregnancy. Results There were no significant differences in the depth of the uterine cavity, the relationship between the length of the mediastinum and the depth of the uterus and the width of the mediastinum in the three groups before operation (P> 0.05). Hysteroscopy again after March, the incidence of residual septum, postoperative intrauterine adhesions, the three groups did not have statistical significance (P> 0.05). There were no significant differences among the three groups (P> 0.05) in the follow-up period of 2 years after operation, pregnancy status, spontaneous abortion, first pregnancy after operation and so on. Conclusion Hysteroscopic resection of uterine septum has significant clinical effect on uterine septum with good pregnancy outcome. Different postoperative management methods (estrogen, IUD, etc.) do not improve the clinical efficacy and pregnancy outcomes.