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    孙艳平. 纵隔子宫两侧内膜夹角与宫腔镜子宫纵隔切除术后纵隔残余和妊娠结局的关系[J]. 蚌埠医科大学学报, 2019, 44(6): 774-777. DOI: 10.13898/j.cnki.issn.1000-2200.2019.06.022
    引用本文: 孙艳平. 纵隔子宫两侧内膜夹角与宫腔镜子宫纵隔切除术后纵隔残余和妊娠结局的关系[J]. 蚌埠医科大学学报, 2019, 44(6): 774-777. DOI: 10.13898/j.cnki.issn.1000-2200.2019.06.022
    shu
    SUN Yan-ping. Relationships between the angle of the endometrium of two sides of the septum and mediastinal residue after TCRS, and pregnancy outcome[J]. Journal of Bengbu Medical University, 2019, 44(6): 774-777. DOI: 10.13898/j.cnki.issn.1000-2200.2019.06.022
    Citation: SUN Yan-ping. Relationships between the angle of the endometrium of two sides of the septum and mediastinal residue after TCRS, and pregnancy outcome[J]. Journal of Bengbu Medical University, 2019, 44(6): 774-777. DOI: 10.13898/j.cnki.issn.1000-2200.2019.06.022
    shu

    纵隔子宫两侧内膜夹角与宫腔镜子宫纵隔切除术后纵隔残余和妊娠结局的关系

    Relationships between the angle of the endometrium of two sides of the septum and mediastinal residue after TCRS, and pregnancy outcome

      摘要
    • 摘要:
      目的探讨纵隔子宫两侧内膜夹角与宫腔镜子宫纵隔切除术（TCRS）后纵隔残余和妊娠结局的关系。
      方法选取不孕、流产等病人80例，均行经阴道三维超声（3DTVU）检查为纵隔子宫，诊断后行经宫腹腔镜联合行TCRS治疗。根据术前3DTVU对两侧内膜夹角的测量情况，以90°为分界，将病人分为大角度组（≥ 90°）和小角度组（< 90°）；纵隔残余标准为术后纵隔长度超过0.5 cm。术后复查，并随访。
      结果宫腔镜下TCRS术与术前经3DTVU诊断结果相同。术后3个月复查，59例不存在纵隔残余或残余不超过0.5 cm；21例纵隔残余超过0.5 cm。大角度组纵隔残余率43.48%，明显高于小角度组纵隔残余的15.79%（P < 0.01）。大小角度组各存在纵隔残余长度超过1.0 cm者1例，进行二次手术治疗，大角度组出现宫腔粘连3例，行粘连松解术治疗。术后随访率为80.00%，大、小角度组累计妊娠率分别为52.63%和44.44%，累计活胎分娩率分别为21.05%和33.33%，差异均无统计学意义（P>0.05）。大角度组自发性流产1例，小角度组自发性流产3例，差异亦无统计学意义（P>0.05）。
      结论纵隔子宫两侧内膜夹角对TCRS术后妊娠结局的影响作用可能与术后并发症的发生率有关，仍需进一步研究。

       

      Abstract:
      ObjectiveTo investigate the relationships between the angle of the endometrium of two sides of the septum, and mediastinal residue after transcervical hysteroscopic resection of septum(TCRS) and pregnancy outcome.
      MethodsThe mediastinal uterus in 80 patients with infertility or abortion were diagnosed using 3DTVU, and the patients were treated with hysteroscopy combined with TCRS.According to the results of 3DTVU, the patients were divided into the large angle group(the angle of the endometrium of two sides of the septum ≥ 90°) and small angle group(the angle of the endometrium of two sides of the septum < 90°).The postoperative mediastinal length more than 0.5 cm was set as the criteria of mediastinal residue.All patients were reviewed and followed up.
      ResultsThe results of TCRS and preoperative diagnosis of 3DTVU were the same.At 3 months after surgery, no mediastinal residue or no more than 0.5 cm residue in 59 cases, and mediastinal residue more than 0.5 cm in 21 cases were found.The residue rate in large angle group(43.48%) was significantly higher than that in small angle group(15.79%)(P < 0.01).The mediastinal length more than 1 cm in 1 case in large angle group and 1 case in small angle group was found, and two cases were treated with operation again.Three cases with intrauterine adhesion in large angle group were found, and treated with adhesion lysis.The follow-up rate of patients was 80.00%.The cumulative pregnancy rate and cumulative live birth rate in large angle group and small angle group were(52.63% and 44.44%) and(21.05% and 33.33%), respectively, and the differences of those between two groups were not statistically significant(P>0.05).One case with spontaneous abortion in large angle group and 3 cases with spontaneous abortion in small angle group were found, and the difference of which between two groups was not statistically significant(P>0.05).
      ConclusionsThe effects of the angle of the endometrium of two sides of the septum on the pregnancy outcome after TCRS may be related to the incidence rate of postoperative complications, which need to be further studied.

       

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