宫腔镜在先天性阴道斜隔诊治中的应用

Application of hysteroscopy in the diagnosis and treatment of congenital oblique vaginal septum

目的:探讨宫腔镜在先天性阴道斜隔诊治中的应用价值。方法:对本院1998～2008年收治的47例先天性阴道斜隔患者的临床表现、治疗方法及治疗效果进行回顾性分析,重点探讨宫腔镜下阴道斜隔切除术的临床应用价值。结果:47例患者中未婚31例,已婚16例;Ⅰ型阴道斜隔29例,Ⅱ型11例,Ⅲ型7例;痛经47例,阴道流液或流脓者16例,经期延长或不规则阴道流血者22例,阴道壁囊肿者47例;阴道斜隔切开术4例,术后仍持续痛经,3例有不规则阴道流液的症状,1例于术后1.5年因阴道斜隔切口粘连再次形成阴道侧壁囊肿而再次行宫腔镜阴道斜隔切除术;行阴道斜隔切除术43例,失访4例,阴道流液或流脓、经期延长或不规则阴道流血等症状完全消失,6例痛经症状完全消失,33例较前明显缓解,所有患者无并发症,无低钠血症发生,无中转其他手术。结论:宫腔镜是先天性阴道斜隔诊疗中的重要手段,宫腔镜下阴道斜隔切除术安全有效、创伤小,保护了处女膜的完整性,宜作为先天性阴道斜隔的首选手术方式。

Objective：To explore the value of hysteroscopy in the diagnosis and treatment of congenital oblique vaginal septum.Methods：Retrospective analysed the clinical manifestations,treatment methods and efficacy of 47 patients with congenital oblique vaginal septum,to investigate the application of hysteroscopy in the diagnosis and treatment on congenital oblique vaginal septum.Results：Among the 47 patients,31 cases were unmarried,29 cases of typeⅠ,11 cases of typeⅡ,7 cases of typeⅢ;47 cases of dysmenorrheal.16 cases vagina flowed liquid or purulence,22 cases with extended or irregular menstrual vaginal bleeding,47 cases of vaginal wall cysts,4 cases of oblique vaginal septum incision,3 cases of irregular vaginal symptoms of flowed liquid.After the operation,four cases lost review,symptoms as vagina flowed liquid or purulence,extended or irregular menstrual vaginal bleeding and other symptoms completely disappeared,six cases of dysmenorrhea symptoms completely disappeared,33 cases of obvious relief than before,there was no complication,no hyponatremia occurred,no transfer to other operations.Conclusion：Hysteroscopy is the important tools in diagnosis and treatment of congenital oblique vaginal septum.