宫腔镜电切术治疗子宫纵隔25例分析

Study of hysteroscopic eletrotomy in 25 women with a septate uterus

目的评估宫腔镜电切术治疗子宫纵隔的效果。方法回顾性分析25例子宫纵隔患者的诊断及在超声或腹腔镜监护下行宫腔镜子宫纵隔切除术(TCRS)的效果。结果B超的诊断符合率为92.0%,子宫输卵管造影术的诊断符合率为23.0%。宫腔镜子宫纵隔切除术中采用B超监视21例,腹腔镜监视4例,手术顺利,无并发症发生。术后随访24例,B组失访1例。术后A组妊娠6例,妊娠率40.0%。B组妊娠6例,妊娠率66.7%,其中有5例已足月妊娠分娩,足月活产率为55.6%(5/9)。结论宫腔镜检术是诊断子宫纵隔的最准确方法,目前宫腔镜电切术治疗子宫纵隔是一种安全、简单、有效、最好的方法。

Objective: To evaluate the clinical value of diagnosis and treatment in uterine septum by hysteroscopy. Methods: This article is a retrospective review of 25 cases with uterine septum from 1998~2003, all patients were diagnosed by hysteroscope and treated by hysteroscopic resection. These operations were monitored by B-ultrasound or laparoscope. Results: B-ultrasound was in agreement with 23 of 25 patients (92.0%), identical rates of Hysterosalpingography (HSG) was 23.0%. During transcervical resection of septum (TCRS) 21 cases were monitored by B-ultrasound and 4 cases by laparoscope. All operations were successful with no complication. 24 cases accepted post-operative follow-up, 6 in group A (40.0%) achived pregnancy; 6 in group B (66.7%) achieved pregnancy and 5 patients (55.6%) had a term delivery. Conclusions: Hysteroscopic diagnosis and treatment of uterine septa is a safe, simple and effective procedure. It should be preferred.