宫腔镜手术治疗子宫纵隔的临床研究

The application of hysteroscopy on septate uterus

目的探讨宫腔镜电切手术对子宫纵隔的疗效及临床应用价值。方法对53例子宫纵隔患者采取宫腔镜、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和术后受孕情况。结果 53例均一次完成手术,无并发症发生。单纯宫腔镜手术后2 d出院,宫腹腔镜联合治疗术后3天出院,术中B超监护3例（5.7%）,单纯腹腔镜监护3例（5.7%）,宫腹腔镜联合治疗手术13例（26%）,未行腹腔镜或B超监护33例（63%）,单纯宫腔镜手术5~15 min,术中出血极少。术后妊娠率70%,流产率3%,术后受孕率较术前均明显提高术后流产率明显下降。结论宫腔镜电切术是微创的诊治子宫纵隔安全、有效的最佳方法,根据子宫畸形情况、纵隔类型和有无盆腔合并症选择合适的手术及监护。

Objective To Study the safety and efficacy of hysteroscopy combined with resection on septate uterus.Methods A total of 53 patients suffered septate uterus were enrolled,and each patient underwent therapy of hysteroscopic,hysteroscopy-laparoscopic or ultrasound guided hysteroscopy surgery.Perioperative data and postoperative pregnancy were collected.Results All patients were performed successfully the surgery without any complication or reoperation.Average hospital during time in hysteroscopic group and hysteroscopy-laparoscopic group was 2 and 3 days respectively.Among all the patients,3 patients were adopted ultrasound guided,3patients were undergone laparoscopic guided.13 patients were taken hysteroscopy-laparoscopic surgery,the other 33 patients were only gone through hysteroscopic surgery.The hysteroscopic surgical time was 5 to 15 minutes with little hemorrhage.Pregnancy and abortion rate was 70% and 3% after surgery.Conclusion Hysteroscopic surgery for septate uterus manifested to be a safe and effective approach.Moreover the surgical approach can be modified according to patients’ uterus feature and complication.