B超监测在畸形子宫宫腔手术中的临床应用价值

Clinical application value of B-mode ultrasound guidance in intrauterine operations for malformed uteruses

目的探讨B超监测在畸形子宫宫腔手术中的临床应用价值。方法回顾性分析我院B超监测下施行宫腔手术的195例畸形子宫病例的相关临床数据。结果 1195例畸形子宫类型中,双子宫73例,纵隔子宫95例,双角子宫10例,弓形子宫17例;2B超监测引导下施行早孕人工流产或清宫术162例,手术一次成功155例(95.7%),二次清宫6例(3.7%),失败1例(0.6%);引产或产后胎盘残留清宫术9例,手术一次成功5例,二次清宫4例;诊断性刮宫或/及取环术24例,手术均一次成功;3畸形子宫人流清宫术需二次清宫与合并其他高危因素相关,高危因素风险依次为产后胎盘残留、稽留流产、宫角妊娠。结论 B超监测下对畸形子宫施行宫腔手术克服了传统宫腔操作的盲目性,减少了子宫内膜损伤,避免了漏吸、子宫穿孔等并发症的发生,提高了手术的安全性和成功率,同时又为及时修复子宫内膜提供依据。

Objective To evaluate the value of B-mode ultrasound guidance in intrauterine operations for malformed uteruses. Methods The data of 195 cases of intrauterine operations for malformed uteruses under B-mode ultrasound guidance in our hospital was analyed retrospectively. Results ①In these 195 cases of malformed uteruses,included 73 cases of didelphys,95 cases of septate,10 cases of bicornuate uterus,and 17 cases of arcuate uterus. ②One-time successful rate for artificial abortion for early pregnancy under ultrasound guidance was 95.7%（155/162）,two-time successful rate of curettage was 3.7%（6/162）,only one case failed（0.6%）. 9 cases of residual placenta with uterine curettage,one-time successful rate was 5/9,two-time successful rate of curettage was 4/9. 24 cases for diagnostic curettage and IUD extraction had been done successfully. The second time of uterine curettage was correlated with some high risk factors including residual placenta,missed abortion,angular pregnancy.Conclusion B-mode ultrasound guidance is a safe and useful method for the malformed uteruses intrauterine operations in increasing operative effectiveness,decreasing complications occurrence,and providing evidence for repairing endometrium.