TCRM治疗子宫肌瘤伴不孕生殖预后分析.docVIP

TCRM治疗子宫肌瘤伴不孕生殖预后分析 　　【摘要】 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（P0.05）。手术前后各组自然流产率比较， 差异具有统计学意义 （P0.05）。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。 　　【关键词】 宫腔镜子宫肌瘤电切术；腹腔镜子宫肌瘤剔除术；子宫肌瘤伴不孕；妊娠结局 　　DOI：10.14163/j.cnki.11-5547/r.2015.18.013 　　Analysis of prognosis of TCRM in the treatment of uterine fibroid complicated with infertility LIU Yu， WANG Ming-bo， LI Qiong. Affiliated Donghua Hospital of Sun Yat-sen University， Dongguan 523110， China 　　【Abstract】 Objective To analyze pregnancy outcome by transcervical resection of myoma （TCRM） in the treatment of uterine fibroid complicated with infertility， in order to provide reference for optimal surgical plan. Methods There were 86 patients undergoing trans-laparoscopy myomectomy （TLM） as TLM group， and 72 patients undergoing TCRM for main treatment of uterine fibroid as TCRM+TLM group. All patients received follow-up for 6～36 months， and their postoperative pregnancy rate， and spontaneous abortion rate before and after operation were observed. Results The difference of cumulative pregnancy times and spontaneous abortion rate between the two groups had no statistical significance before operation （P0.05）. The difference of spontaneous abortion rate between the two groups before operation had statistical significance （P0.05）. Conclusion TCRM in treating uterine fibroid complicated with infertility provides little uterine damage， with increased pregnancy rate and decreased spontaneous abortion rate. Its combination with TLM can provide assessment and treatment for pelvic cavity， and that is much better than single TLM treatment. 　　【Key words】 Transcervical resection of myoma； Trans-laparoscopy myomectomy； Uterine fibroid complicated with infertility； Pregnancy outcome 　　对于已达育龄的妇女来说， 子宫肌瘤很常见， 是一种良性肿瘤。其发病率在20%～50%之间。近年随着我国妇女结