腹腔镜监视下宫腔镜子宫纵隔切开术治疗子宫纵隔110例临床分析

Clinical analysis of 110 cases which were treated with transcervical resection of septum with laparoscopic monitoring

目的 探讨宫腹腔镜联合手术治疗纵隔子宫的临床疗效及其应用价值。方法 选取该院2010年1月—2014年1月入院手术治疗的有生育要求的纵隔子宫患者110例,行腹腔镜监视下宫腔镜子宫纵隔切开术,腹腔镜处理同时存在的盆腔疾病,跟踪随访术后妊娠结局。结果 所有病例手术均一次性成功,纵隔切除时间8-25 min,术中出血（20±7）m L,无严重手术并发症发生;术后3个月宫腔镜检查子宫形态均接近正常;随访时间12-60个月,90例在术后获妊娠1-4次,其中足月产80例,流产41例,早产6例,妊娠率82%。结论 宫腹腔镜联合手术是治疗纵隔子宫最安全、最有效的方法,也是治疗纵隔子宫合并盆腔病变的首选方法,可提高患者妊娠率及改善生育结局。

Objective To evaluate the effects and the value of transcervical resection of septum（TCRS）with laparoscopic monitoring in treating patients with uterine septum.Methods 110 patients with uterine septum from January 2010 to January 2014 were treated with TCRS with laparoscopic monitoring,while pelvic diseases were treated with laparoscopic -surgery ,investigate the pregnancy rates and outcomes.Results All patients were treated successfully at one -time,the mediastinal resection time were 8 -25 min,the blood loss was （20±7）mL,no serious complications occurred;hysteroscopy uterine morphology were close to normal 3 months later;the investi-gate -time was 12 to 60 months,90 cases were pregnant 1 -4 times,including 80 cases of full -term ,41 cases of miscarriage,6 cases of premature birth,the pregnancy rate was 82%.Conclusion TCRS with laparoscopic monitoring is the safest and the most effective treatment of uterine septum and also the preferred method of treating patients who have pelvic diseases at the same time;pregnancy rates could be enhanced and fertility outcomes could be improved obviously.