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目的:探讨宫腔镜联合腹腔镜手术治疗完全纵膈子宫伴阴道纵隔的临床效果。方法:回顾性分析我院妇科微创中心行腹腔镜监护下宫腔镜子宫纵隔切除+阴道纵隔切除术的40例完全纵隔子宫伴阴道纵隔患者的临床资料,并随访其术后妊娠结局。结果:40例患者成功随访1~6年,术后累计妊娠46次,自然流产率由术前的87.3%下降到30.4%,足月活产率由0.0%上升到58.7%,无胎盘植入、胎盘粘连等妊娠期并发症发生。结论:宫腔镜联合腹腔镜手术安全有效,可明显改善纵隔子宫合并阴道纵隔患者的妊娠结局,不增加孕期并发症,建议在临床上推广应用。
Objective: To explore the clinical effect of hysteroscopy combined with laparoscopic surgery for complete mediastinal uterus with vaginal mediastinum. Methods: The clinical data of 40 patients with complete mediastinal uterus and vaginal mediastinum underwent laparoscopic surveillance of hysteroscopic mediastinal resection and vaginal mediastinal dissection underwent laparoscopic retrospective analysis were retrospectively analyzed. The postoperative pregnancy outcomes were followed up. Results: Forty patients were successfully followed up for 1 to 6 years. The total number of pregnancies after pregnancy was 46. The rate of spontaneous abortion decreased from 87.3% preoperatively to 30.4%, and the full-term live birth rate increased from 0.0% to 58.7% , Placenta accreta pregnancy complications. Conclusion: Hysteroscopy combined with laparoscopic surgery is safe and effective, can significantly improve the pregnancy outcome of patients with mediastinial uterus and vaginal mediastinal complications, do not increase complications during pregnancy, it is recommended for clinical application.