摘要
目的总结并分析宫腔镜下子宫纵隔切除术(TCRS)术后患者近、远期生殖状况及相关并发症情况。方法 2006年3月～2011年8月TCRS手术治疗180例子宫纵隔,所有患者自宫腔镜二探后随访12个月以上。利用病历资料、手术记录及电话随访,分析术前、术后妊娠结局,并与同期2241例正常结构子宫妊娠妇女(对照组)的分娩结局进行比较。结果①术中及术后无1例患者出现手术并发症,术后115人妊娠中24例距宫腔镜二探术后时间最短为1个月即怀孕(占20.87%)。②TCRS术后自然流产率为15.08%,明显低于术前组62.98%,活产率为70.63%,明显高于术前组2.42%。③TCRS术后剖宫产率80.9%,明显高于对照组42.2%,剖宫产原因中社会因素所占比例最高41.67%,明显高于对照组17.35%,TCRS术后组产后出血率25.84%,其中39.13%需要输血,均明显高于对照组的产后出血率14.54%及输血治疗率8.28%,其中合并前置胎盘的产后出血患者最多。讨论 TCRS术后近期无严重并发症发生,短期内即可妊娠,生殖预后明显改善,主要体现在自然流产率降低、活产率明显增高。目前患者多采用剖宫产分娩,但积极努力减少社会因素剖宫产病例应该可以改善现状。TCRS术后远期需要关注孕期中前置胎盘患者的监护。
【Objective】To summarize and analyze the short-term and long-term reproductive conditions and related complications after transcervical resection of septa.【Methods】180 women with septate uterus underwent transcervical resection of septa in our department between March, 2006, and August, 2011. All patients were followed up for more than 12 months after the second examination of hysteroscopy. With the help of medical records, operation reports, as well as telephone contact, we analyzed the preoperative and postoperative reproductive outcomes, and compared it with 2241 normal pregnant women in the same period. 【Results】①There was no intraoperative and postoperative complications, 20.87% (24/115) cases were pregnant in one month after the second examination of hysteroscopy. ②The spontaneous abortion rate in post-TCRS was 15.08%, which was significantly lower than the pre-TCRS group of 62.98%. The live birth rate of 70.63%, was significantly higher than the preoperative group of 2.42%. ③The rate of cesarean section in the group of post-TCRS (80.9%) was significantly higher than normal(42.2%). The rate of cesarean section without indications in post-TCRS group (41.67%) was significantly higher than the normal (17.35%). The incidence of postpartum hemorrhage and the rate of blood transfusion patients in postTCRS were 25.84% and 39.13%, which was higher than the normal (14.54%, 8.28%) respectively. Placenta previa is the main reason for postpartum hemorrhage.【Conclusions】No serious complications occurred within short-term after TCRS, the patients can conceive as soon as possible after the second time examination of hysteroscopy. The reproductive prognosis improved significantly, which mainly reflected in the spontaneous abortion rate decrease and live birth rate increase significantly. We need to reduce the rate of cesarean section without indications to improve the present situation. The patients with placenta previa are the main monitored group during pregnancy.
出处
《中国内镜杂志》
CSCD
北大核心
2012年第12期1233-1236,共4页
China Journal of Endoscopy
关键词
子宫纵隔
宫腔镜
回顾性分析
妊娠结局
uterus septa
hysteroscopy
retrospective studies
pregnancy outcome
