宫腔镜或宫腹腔镜联合手术治疗子宫纵隔69例疗效观察

Clinical effect of hysterocopy or laparoscopy combined with hysteroscopy for patients with uterine septum

目的:探讨宫腔镜或宫腹腔镜联合在治疗子宫纵隔中的临床疗效。方法:对69例子宫纵隔患者行宫腔镜子宫纵隔电切术(26例)或腹腔镜监视下宫腔镜纵隔切开术(43例)的临床效果进行回顾性分析。结果:69例患者均一次手术成功,手术时间为20～105 min,平均手术时间(42.3±6.8)min;术中出血10～45 ml,平均出血量为(18.2±3.2)mL;其中无子宫穿孔、水中毒、感染及大出血等并发症,随访6～33个月,自然流产率由术前的71.4%降到术后的14.8%,不孕症患者术前为39.1%明显下降至11.6%。结论:宫腔镜或宫腹腔镜联合电切术治疗子宫纵隔安全、有效,能显著改善患者的妊娠结局,提高患者的妊娠率。

Objective：To evaluate the clinical effect in the uterine septum by hysterocopy or laparoscopy combined with hysteroscopy.Methods：Sixty-nine cases with uterine septum were retrospectively analyzed.26 patientes were performed transcervical hysteroscopic resection of septum（TCRS）,and 43 patients were performed TCRS being monitored by laparoscopy.Results：All operations were successful,The operation time was 20～105 min.The average time for operation was（42.3±6.8） min.The blood loss was10～45 ml.The average blood loss was（18.2±3.2） mL.No uterine perforation,water intoxication,infection,bleeding and other complications occurred.6 to 33 months follow-up,the abortion rate decreased from 71.4 % to 14.8 %,Infertility patients decreased from 39.1% to 11.6%.Conclusion：TCRS by hysterocopy or laparoscopy combined with hysteroscopy treating uterine septum resection is safe and effective,which significantly improves the pregnancy outcomes of patients and improves the pregnancy rate of patients.