宫腔镜手术治疗子宫纵隔的临床研究

Analysis of hysteroscopy incision in septate uterus

目的探讨宫腔镜电切术对子宫纵隔的临床应用价值。方法对97例子宫纵隔患者采用宫腔镜、宫腹腔镜联合或宫腔镜/B超联合诊治,并对患者的临床资料进行分析,以评价手术及监护方式。结果97例均一次完成手术,无并发症发生。单纯宫腔镜手术者术后平均住院日3d,宫腔镜腹腔镜联合手术者平均住院日5d。术中B超监护6例(6.2%);单纯腹腔镜监护3例(3.1%);宫、腹腔镜联合手术26例(26.8%);未行腹腔镜或B超监护62例(63.9%)。单纯宫腔镜手术3～12min,平均时间(7.5±4.1)min,术中出血极少。结论宫腔镜电切术是诊治子宫纵隔安全、有效的的最佳方法,按照子宫畸形情况、纵隔类型和有无盆腔合并症选择合适的手术及监护方法。

[Objective] To evaluate the clinical value of hysteroscopic resection in septate uterus. [Methods] Ninety-seven cases with septate uterus were retrospectively analyzed after examined in different ways and performed transcervical hysteroscopic resection of septum （TCRS） with or without being monitored by B-ultrasound or laparoscopy. [Results] All patients were cured successfully at the first operation without complication. 6 patients （6.2%） received hysteroscopic resection under the surveillance by B-ultrasound and 3 patients （3.1%） by laparoscopy; 62 patients （63.9%） without being monitored; The other 26 patients （26.8%） combined with laparoscopy surgery. The operative time of the patients who only received hysteroscopic resection without being monitored was 3-12 min and the average time was （7.5±4.1） min. [Conclusion] Uterine septum resection with hysteroscopy is a safe, simple and effective method. We can choose the suitable operative modes and monitoring methods according to the type of septate uterus with or without pelvic disorder and so on.