国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2018, Vol. 37 ›› Issue (2): 99-102.

• 论著 • 上一篇    下一篇

宫腹腔镜联合完全双角子宫矫形术的生殖预后

刘琳琳，黄晓武，夏恩兰   

  1. 100038  北京，首都医科大学附属复兴医院宫腔镜诊治中心
  • 收稿日期:2018-02-22 修回日期:2018-02-28 出版日期:2018-03-15 发布日期:2018-03-15
  • 通讯作者: 夏恩兰，E-mail：xiaenlan@126.com E-mail:xiaenlan@126.com;xiaenlan@public.bta.net.cn

Reproductive Outcome of Metroplasty by Laparoscopy Combined with Hysteroscopy for Complete Bicornuate Uterus

LIU Lin-lin，HUANG Xiao-wu，XIA En-lan   

  1. Hysteroscopy Center，Fuxing Hospital Affiliated to Captial Medical University，Beijing 100038，China
  • Received:2018-02-22 Revised:2018-02-28 Published:2018-03-15 Online:2018-03-15
  • Contact: XIA En-lan，E-mail：xiaenlan@126.com E-mail:xiaenlan@126.com;xiaenlan@public.bta.net.cn

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摘要： 目的：探讨完全双角子宫患者行宫腹腔镜联合子宫矫形术对生殖预后的改善情况。方法：回顾性分析2006年10月—2015年11月在首都医科大学附属复兴医院宫腔镜诊治中心行宫腹腔镜联合子宫矫形术的完全双角子宫患者19例的病例资料，并随访妊娠结局。结果：19例患者随访时间为2～11年，失访4例。随访到的15例患者术后有效避孕1年，妊娠9例，未妊娠6例，术后首次妊娠时间为子宫矫形术后14～46个月。9例妊娠的患者中，术后自然流产率（10.0% vs. 90.5%）、足月分娩率（50.0% vs. 0）和获活婴率（80.0% vs. 0）均较术前有明显改善，差异有统计学意义（均P＜0.05）；19例患者中，共有4例完全双角子宫合并宫颈机能不全患者行孕前腹腔镜经腹子宫颈环扎术，其中2例成功妊娠并分娩获得活婴。结论：有不良妊娠结局史的完全双角子宫患者行宫腹腔镜联合子宫矫形术可改善生殖预后。

关键词: 双角子宫, 子宫矫形术, 子宫, 矫形外科学, 手术后期间, 预后, 腹腔镜, 宫腔镜

Abstract: Objective：To explore the improvement of reproductive outcome in those women with a complete bicornuate uterus who underwent metroplasty by the laparoscopy combined with hysteroscopy. Methods: 19 women with complete bicornuate uteri who underwent metroplasty by the laparoscopy combined with hysteroscopy in our hospital from October 2006 to November 2015 were retrospectively analyzed. The pregnancy outcome was followed-up. Results: 19 women were followed up for 2 to 11 years, and 4 of them dropped. In 15 women, 9 cases of pregnancy and 6 cases of non-pregnancy were recorded after their one-year effective postoperative contraception. The first postoperative pregnancy time after metroplasty ranges from 14 to 46 months. For the 9 women who had conception, the rates of spontaneous abortion (90.5% vs. 10.0%), term delivery (0 vs. 50.0%) and "take-home-baby" (0 vs. 80.0%) were recorded before and after the operation (all P＜0.05). Of the 19 patients, a total of 4 patients with complete bicornuate uteri combined with cervical insufficiency underwent laparoscopic abdominal cerclage before pregnancy, and 2 of them achieved successful pregnancy and delivered live babies. Conclusions: The metroplasty by the laparoscopy combined with hysteroscopy can significantly improve the reproductive prognosis for those women with adverse pregnancy outcomes owing to complete bicornuate uterus.

Key words: Bicornuate uterus, Metroplasty, Uterus, Orthopedics, Postoperative period, Prognosis, Laparoscopes, Hysteroscopes

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