目的探究超声联合宫腔镜治疗黏膜下子宫肌瘤的疗效及影响术后妊娠的因素。方法回顾性分析2017年10月—2018年10月就诊于该院的黏膜下子宫肌瘤患者101例,根据手术方式将其分为观察组51例和对照组50例,对照组采取开腹手术治疗,观察组采取...目的探究超声联合宫腔镜治疗黏膜下子宫肌瘤的疗效及影响术后妊娠的因素。方法回顾性分析2017年10月—2018年10月就诊于该院的黏膜下子宫肌瘤患者101例,根据手术方式将其分为观察组51例和对照组50例,对照组采取开腹手术治疗,观察组采取超声联合宫腔镜治疗,随访12~18个月。观察并比较观察组和对照组手术指标、术后并发症发生情况、子宫肌瘤复发率和妊娠率;并用单因素和Logistic多因素分析影响观察组患者术后妊娠的因素。结果观察组患者的手术时间、肛门排气时间、术中出血量、住院时间、下床活动时间均显著低于对照组,差异均有统计学意义(均P<0.05);观察组术后并发症的发生率(21.57%)显著低于对照组(56.00%),差异有统计学意义(P<0.05);观察组子宫肌瘤复发率(3.92%)显著低于对照组(32.00%),妊娠率(68.63%)显著高于对照组(22.00%),差异均有统计学意义(均P<0.05);经单因素和Logistic多因素分析发现,年龄>35岁、体质量指数(body mass index,BMI)>25kg/m2、侵入性操作、宫腔压力、未使用凝胶是造成观察组患者术后不易妊娠的独立危险因素(P<0.05)。结论超声联合宫腔镜治疗黏膜下子宫肌瘤的疗效显著,且年龄、BMI、侵入性操作、宫腔压力、凝胶使用情况会影响患者的术后妊娠。展开更多
Background The true risk of choronic villus sampling(CVS)is poorly defined.The objective of this study was to review the clinical outcome of transabdominal CVS performed in a university teaching unit,with an emphasis ...Background The true risk of choronic villus sampling(CVS)is poorly defined.The objective of this study was to review the clinical outcome of transabdominal CVS performed in a university teaching unit,with an emphasis on the complication rate.Methods A comprehensive audit database was maintained for 1351 pregnant women,including 17 sets ot twin pregnancies,who had a CVS.Details and outcome of all CVSs made in the unit between May 1996 and May 2004 were reviewed.All CVSs were performed by one of 5 operators using the identical techniques.Results All procedures were performed transabdominally.A total of 1355 CVSs were performed because there were 4 dichorionic twin pregnancies which required 2 punctures.The mean gestation at CVS was(11.8+0.7)weeks,and 97.3%of the procedures were performed between 11 and 13 completed weeks.The majority(96.2%)required only 1 puncture to achieve correct needle placement.The procedure failed to obtain an adequate sample in 4 subjects(0.30%).A total of 1351 chromosomal studies were requested and there was 1 case(0.07%)of culture failure.The results of chromosomal studies were available within 14 days in 36.7%of the cases and within 21 days in 94.0%.Overall,77 chromosomal abnormalities(5.7%)and 5 cases of thalassemia major were detected.Pregnancy outcome was unknown in only 13 singleton subjects(0.96%).In the remaining 1355 fetuses,there were 76 pregnancy terminations(5.56%),10 fetal losses with obvious obstetric causes(0.73%),and 21 potentially procedure-related fetal losses(1.54%).In the last group,the majority had one or more co-existing obstetric complications.The background fetal loss rate for pregnancies at similar gestational age in the unit was about 0.8%.Therefore,the procedure-related fetal loss rate was estimated to be at the maximum of 0.74%.Conclusions In experienced hands,first trimester transabdominal CVS is an accurate and safe invasive prenatal diagnostic procedure.It should be one of the treatment options available to pregnant women who require prenatal genetic diagnosis展开更多
文摘目的探究超声联合宫腔镜治疗黏膜下子宫肌瘤的疗效及影响术后妊娠的因素。方法回顾性分析2017年10月—2018年10月就诊于该院的黏膜下子宫肌瘤患者101例,根据手术方式将其分为观察组51例和对照组50例,对照组采取开腹手术治疗,观察组采取超声联合宫腔镜治疗,随访12~18个月。观察并比较观察组和对照组手术指标、术后并发症发生情况、子宫肌瘤复发率和妊娠率;并用单因素和Logistic多因素分析影响观察组患者术后妊娠的因素。结果观察组患者的手术时间、肛门排气时间、术中出血量、住院时间、下床活动时间均显著低于对照组,差异均有统计学意义(均P<0.05);观察组术后并发症的发生率(21.57%)显著低于对照组(56.00%),差异有统计学意义(P<0.05);观察组子宫肌瘤复发率(3.92%)显著低于对照组(32.00%),妊娠率(68.63%)显著高于对照组(22.00%),差异均有统计学意义(均P<0.05);经单因素和Logistic多因素分析发现,年龄>35岁、体质量指数(body mass index,BMI)>25kg/m2、侵入性操作、宫腔压力、未使用凝胶是造成观察组患者术后不易妊娠的独立危险因素(P<0.05)。结论超声联合宫腔镜治疗黏膜下子宫肌瘤的疗效显著,且年龄、BMI、侵入性操作、宫腔压力、凝胶使用情况会影响患者的术后妊娠。
文摘Background The true risk of choronic villus sampling(CVS)is poorly defined.The objective of this study was to review the clinical outcome of transabdominal CVS performed in a university teaching unit,with an emphasis on the complication rate.Methods A comprehensive audit database was maintained for 1351 pregnant women,including 17 sets ot twin pregnancies,who had a CVS.Details and outcome of all CVSs made in the unit between May 1996 and May 2004 were reviewed.All CVSs were performed by one of 5 operators using the identical techniques.Results All procedures were performed transabdominally.A total of 1355 CVSs were performed because there were 4 dichorionic twin pregnancies which required 2 punctures.The mean gestation at CVS was(11.8+0.7)weeks,and 97.3%of the procedures were performed between 11 and 13 completed weeks.The majority(96.2%)required only 1 puncture to achieve correct needle placement.The procedure failed to obtain an adequate sample in 4 subjects(0.30%).A total of 1351 chromosomal studies were requested and there was 1 case(0.07%)of culture failure.The results of chromosomal studies were available within 14 days in 36.7%of the cases and within 21 days in 94.0%.Overall,77 chromosomal abnormalities(5.7%)and 5 cases of thalassemia major were detected.Pregnancy outcome was unknown in only 13 singleton subjects(0.96%).In the remaining 1355 fetuses,there were 76 pregnancy terminations(5.56%),10 fetal losses with obvious obstetric causes(0.73%),and 21 potentially procedure-related fetal losses(1.54%).In the last group,the majority had one or more co-existing obstetric complications.The background fetal loss rate for pregnancies at similar gestational age in the unit was about 0.8%.Therefore,the procedure-related fetal loss rate was estimated to be at the maximum of 0.74%.Conclusions In experienced hands,first trimester transabdominal CVS is an accurate and safe invasive prenatal diagnostic procedure.It should be one of the treatment options available to pregnant women who require prenatal genetic diagnosis
