超声监护在完全子宫纵隔伴有双宫颈双阴道畸形宫腔镜电切术的临床应用

Clinical application of ultrasound guidance for hysteroscopic surgeries in complete septate uterus with double cervix and longitudinal vaginal septum

目的探讨超声监视下宫腔镜电切术治疗完全子宫纵隔伴有双宫颈双阴道畸形的临床价值。方法在超声监视下,对17例完全子宫纵隔伴有双宫颈双阴道患者行宫腔镜子宫纵隔切开术。结果在超声监视下17例均一次完成纵隔电切手术,无子宫穿孔,膀胱、肠管损伤及水中毒等并发症。术后1年随访,宫腔形态正常,无粘连积血。17例患者术后妊娠情况与术前妊娠情况比较:足月活产率明显增高,流产及早产率明显下降,均有显著性差异(P<0.001),足月分娩者均未发生子宫破裂、胎盘植入及产后大出血等分娩并发症发生。结论超声监护可以辅助完全子宫纵隔伴有双宫颈双阴道畸形宫腔镜电切术顺利进行并取得良好的效果,值得推广。

Objective To assess the value of ultrasound guided hysteroscopic surgeries for complete septate uterus with double cervix and longitudinal vaginal septum. Methods Seventeen patients who had a complete septate uterus with double cervix and longitudinal vaginal septum underwent the resection of uterine septum by ultrasound guided hysteroscopic sur geries. Results Seventeen patients were all successfully treated without complications of perforation of the uterus, injury of the bladder, bowel and water intoxication, etc. The patients were followed-up for 1 year, and the shape of uterine cavity was normal without adhesion and storing blood. Compared to the reproductive outcome before operation, full-term live birth rate improved greatly, abortion rate and preterm delivery rate decreased significantly （P〈0. 001 ）, and those patients who deliveried full-termly didn＇t encounter the delivery complications such as uterine rupture, placenta implantation and postpartum hemorrhage. Conclusion Ultrasound guidance can assist hysteroscopic surgeries to treat complete septate ute rus with double cervix and longitudinal vaginal septum effectively.