宫腔镜子宫中隔切除术后妊娠相关因素分析

Influencing factors analysis of the postoperative pregnancy in patients with uterine septum

摘要:

目的  分析子宫中隔对妊娠结局的影响，探讨宫腔镜下子宫中隔切除术（TCRS）后妊娠的相关因素。方法  回顾性分析行宫腔镜下TCRS并有生育要求的随访资料完整的125例患者的临床资料，分析手术前后妊娠结局差异以及术后妊娠相关因素。结果  TCRS手术前、后自然流产率分别为70.40%和19.39%，活产率分别为10.40%和72.45%，差异有统计学意义（P <0.05）。患者年龄≥35岁者与<35者比较，前者术后自然流产率更高，活产率更低，差异均有统计学意义。术前不同的宫腔操作次数、自然流产次数和中隔长度等术后妊娠比较差异均无统计学意义。结论  宫腔镜下子宫中隔切除术可明显改善妊娠结局。术后妊娠受患者年龄的影响，而与术前自然流产次数、中隔状态及术后治疗方式等可能无关。

Abstract:

Objective To analyze the impact of uterine septum on pregnancy and influencing factors on postoperative pregnancy. Methods 125 patients with septate uterus and bearing requirement who underwent TCRS were followed up to assess fertility outcome. The clinical data was retrospectively analyzed. Results Spontaneous abortion rate was 70.40 % and 19.39 %, live birth rates was 10.40 % and 72.45 % in preoperation and postoperation respectively. The difference was statistically significant (P < 0.05). Spontaneous abortion rate in older than 35 years old group was significantly higher than that in younger than 35 years old group, but live birth rate was lower. There was no significant difference in different times of operation in uterine cavity, number of abortion and septum length and so on. Conclusions TCRS can significantly improve pregnancy outcome. The age has influence on postoperative pregnancy outcome. Abortion numbers, septum length, septal base width, intrauterine device (IUD) and hormone replacement therapy (HRT) may have no effects.