陈旧性子宫壁假道临床分析—附33例报道

An analysis of 33 cases of false uterine passage

目的探讨陈旧性子宫壁假道的诊断与预防子宫壁假道的方法。方法 2013年1月-2015年1月该中心行超声联合宫腔镜检查诊断陈旧性子宫壁假道33例,分析其发生原因、超声及宫腔镜下特点。结果 33例患者中子宫壁假道发生在宫颈25例,占75.8%,宫体8例,其中,子宫过度前屈及后屈84.9%;子宫壁假道长度≤1.5 cm 11例,1.5～3.0 cm 16例,〉3 cm 6例;宫腔完全封闭15例,其中,宫腔镜检查时分离并进入宫腔3例。结论子宫壁假道多发生于宫颈,与子宫体过度屈曲有关,超声引导的宫腔操作可能会减少宫壁假道的发生。

【Objective】To explore the causation and prevention of a false uterine passage created during previous uterine surgery.【Methods】A total of 33 cases of false uterine passage sustained during a previous hysteroscopic surgery were managed in our hospital from Jan 2013 to Jan 2015. The underlying causes and the diagnostic features of false uterine passage were reviewed. 【Results】In 33 patients, the false uterine passage was located in the cervix in 25 cases and located in uterine body in 8 cases. Excessive flexion of the uterus accounted for 84.9% of cases. The depth of false passage was less than or equal to 1.5 cm in 11 cases, between 1.5 and 3 cm in 16 cases,and more than 3 cm in 6 cases. The uterine cavity was completely obliterated because of Asherman＇s syndrome in15 cases. The uterine cavity was successfully entered under ultrasound guidance in 3 cases out of the 15 cases.【Conclusion】The false passage mostly occurred in the cervix. It is associated with excessive flexion of uterine body. Cervical dilation with ultrasound guidance may reduce the occurrence of a false passage.