宫腔镜下子宫纵隔切除效果分析及不同术后宫腔粘连预防方法比较.docVIP

宫腔镜下子宫纵隔切除效果分析及不同术后宫腔粘连预防方法比较 　　[摘要] 目的 探讨宫腔镜下子宫纵隔切除的效果，并比较不同术后宫腔粘连预防方法的价值。 方法 选择2010年1月～2012年12月本院收治的子宫纵隔患者96例，随机分为三组，各32例，均行宫腔镜下子宫纵隔切除术治疗，为预防宫腔粘连，A组患者术后放置圆形宫内节育器（3个月后取出），B组患者术后口服雌激素（2个月），C组患者未进行特殊处理。术后3个月行宫腔镜检查，观察子宫纵隔残留及宫腔粘连情况，术后随访2年，观察各组患者妊娠情况。 结果 术后3个月，A、B、C组术后子宫纵隔残留率分别为12.50%、9.38%、15.62%，差异无统计学意义（P0.05）；A、B、C组宫腔粘连发生率分别为9.38%、6.25%、12.50%，差异无统计学意义（P0.05）。术后2年，三组妊娠率和妊娠时间比较差异无统计学意义（P0.05）。 结论 宫腔镜下子宫纵隔切除安全有效，但术后应用雌激素或节育环对预防宫腔粘连、增加妊娠率等并无明显作用。 　　[关键词] 宫腔镜；子宫纵隔；宫腔粘连；妊娠 　　[中图分类号] R713.4 [文献标识码] A [文章编号] 1674-4721（2015）02（a）-0054-03 　　Effect analysis of uterine septum resection under hysteroscopy and comparison of different postoperative intrauterine adhesion prevention methods 　　JIANG Yong-hong 　　Department of Gynaecology and Obstetrics，People′s Hospital of Wenshan Prefecture in Yunnan Province，Wenshan 663000，China 　　[Abstract] Objective To investigate the effect of uterine mediastinal resection under hysteroscopy and compare the value of different intrauterine adhesion prevention methods. Methods 96 patients with uterine mediastinum from January 2010 to December 2012 in our hospital were selected and randomly divided into three groups，each group of 32 cases，all patients were given hysteroscopic uterine septum resection treatment.After surgery，patients of group A were given IUD placement（removal after three months），patients of group B were given estrogen oral（two months），and patients of group C without special treatment.After operation of 3 months，uterus residual mediastinal and uterine adhesion were observed by hysteroscopy，pregnancy rate was observed in 2 years follow-up. Results After operation of 3 months，postoperative uterus residual mediastinal rate of group A，group B and group C was 12.50%，9.38%，15.62% respectively，with no statistical difference（P0.05）.The incidence of intrauterine adhesions of group A，group B and group C was 9.38%，6.25%，12.50% respectively，with no statistical difference（P0.05）.After operation of 2 years，pregnancy rate and gestational a