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目的探讨不同类型黏膜下子宫肌瘤患者行宫腔镜手术治疗对妊娠结局的影响。方法选取2011年3月至2014年6月间深圳市龙岗区第六人民医院收治的162例黏膜下子宫肌瘤患者,均采用宫腔镜电切除术治疗。根据子宫肌瘤与肌层的关系,将患者分为0型组(78例)、Ⅰ型组(54例)、Ⅱ型组(30例),对3组患者的妊娠结局进行统计对比。结果 0型组患者的足月生产率、流产率、早产率和难产率与Ⅰ型和Ⅱ型组比较,差异均有统计学意义(均P<0.05)。Ⅰ型组与Ⅱ型组患者的足月生产率、流产率和早产率比较,差异无统计学意义(P>0.05)。但Ⅰ型组患者的难产率显著低于Ⅱ型组,差异有统计学意义(P<0.05)。3组患者均未发生子宫破裂(P>0.05)。结论不同类型黏膜下子宫肌瘤患者实施宫腔镜电切除术治疗的妊娠结局存在差异,带蒂肌瘤、肌层扩展越浅,患者的妊娠结局越好,提示黏膜下子宫肌瘤应当早诊断、早治疗。
Objective To investigate the effect of hysteroscopic surgery on pregnancy outcome in different types of submucosal uterine fibroids. Methods From March 2011 to June 2014, 162 cases of submucosal myoma of uterus treated by the Sixth People’s Hospital of Longgang District of Shenzhen City were treated with hysteroscopic resection. According to the relationship between myoma and myometrium, the patients were divided into 0 group (78 cases), Ⅰ group (54 cases) and Ⅱ group (30 cases). The pregnancy outcomes of 3 groups were statistically compared. Results The rates of full-term, abortion, premature delivery and refractory rate in type 0 group were significantly different from those in type 1 and group 2 (all P <0.05). There was no significant difference in term birth rate, abortion rate and premature birth rate between type Ⅰ and type Ⅱ patients (P> 0.05). However, the rate of dystocia in type Ⅰ group was significantly lower than that in type Ⅱ group (P <0.05). All three groups had no uterine rupture (P> 0.05). Conclusion Different types of submucosal uterine fibroids in patients with hysteroscopic resection of the treatment of pregnancy outcomes are different, pedicle fibroids, the more shallow myometrial expansion, the better the outcome of patients with pregnancy, suggesting that submucosal uterine fibroids should be diagnosed early Early treatment.