【摘要】 目的探讨宫腔镜下子宫中隔电切除术对完全中隔子宫、双宫颈、阴道纵隔患者的治疗效果。方法 2004年9月至2013年8月浙江大学医学院附属妇产科医院完全中隔子宫、双宫颈、阴道纵隔住院患者64例,均行宫腔镜下子宫中隔电切除术及阴道纵隔切除术,分为反复流产组(26例)和不孕组(38例),电话或门诊随访妊娠结局。结果反复流产组25例妊娠,累计妊娠31次,自然流产率由术前83.1%(54/65)下降为41.9%(13/31),足月产率、早产率和活产率分别为35.5%(11/31)、19.3%(6/31)和54.8%(17/31),与术前比较差异均有统计学意义(P<0.05);不孕组18例妊娠,妊娠率47.4%(18/38),其中12例足月分娩。研究对象中早产及足月产共32例,早产率28.1%(9/32),足月产率71.9%(23/32)。研究对象胎盘粘连、植入发生率21.9%(7/32),产后出血发生率25.0%(8/32)。结论宫腔镜下子宫中隔电切除术可提高完全中隔子宫、双宫颈、阴道纵隔患者的妊娠率及生殖预后。更多还原

【Abstract】 Objective To evaluate the reproductive prognosis of patients with duplicated cervix and longitudinal vaginal septum undergoing hysteroscopic septum resection of the complete septate uterus.Methods Sixty-four patients with complete septate uterus and duplicated cervix and longitudinal vaginal septum underwent hysteroscopic septum resection. All patients were divided into recurrent abortion group(n=26) and infertility group(n=38) according to their obstetrical situation. The pregnancy outcomes of these patients were followed up by telephone or out-patient clinic.Results In recurrent abortion group, there were 25 women with 31 pregnancies.The abortion rate declined from 83.1%(54/65)to41.9% after operation(13/31).The full-term pregnancy rate, premature delivery and living birth increased to 35.5%(11/31),19.3 %(6/31)and 54.8%(17/31)respectively(P<0.05). In infertile group, there were 18 women pregnant(18/38),including 12 full-term labor. In the research objects,the cases of premature labor and full-term labor were 32.The premature delivery rate was 28.1%(9/32)and the full-term pregnancy rate was 71.9%(23/32).In the research objects,the incidence of placental adherence was 21.9%(7/32),and the incidence of postpartum hemorrhage was 25.0%(8/32). Conclusions The pregnancy rates and reproductive prognosis in the women with complete septate uterus and duplicated cervix and longitudinal vaginal septum is improved after hysteroscopic septum resection.更多还原