宫腔镜与B超联合应用治疗宫腔粘连

Treatment of uterin cavity adhesion by hysteroscope in combination with B-ultrasound

目的 评价宫腔镜与B超联合应用治疗宫腔粘连的临床效果。 方法 在B超监测下行宫颈扩张器或宫腔镜电切分离子宫内粘连 ,术后给予抗生素、人工周期、IUD留置治疗。 结果 5 5例宫腔粘连完全分离 ,无并发症发生。术前闭经或月经稀少 48例 ,术后月经恢复正常 43例 (89 6 % ) ;2 4例痛经治疗后得到缓解。有生育要求的 36例中 2 1例妊娠 (5 8 3% ) ,轻度粘连者妊娠率最高 81 8% (9/11) ,中度粘连者妊娠率 5 4 5 % (12 / 2 2 ) ,重度粘连者没有妊娠 ,差异有统计学意义 (χ2 =6 82 6 ,P =0 0 33)。 结论 宫腔镜与B超联合应用是治疗宫腔粘连的理想方法。术后受孕与宫腔粘连的程度有密切关系。

Objective To investigate the clinical effect of hysteroscope combined with B-ultrasound in the treatment of uterin cavity adhesion. Methods Hegar dilatior or electric knife of hysteroscope was used to cut adhesion, which was monitored by B-ultrasound. Antibotics, artificial hormonal cycle treatment and IUD in uterin cavity were used after operation. Results 55 cases of uterin cavity adhesion were separated completely and had no complication. Amenorrhvea or rare menstrual flow occurred in 48 cases,and menstrual flow recovered in 43 cases (89 6%) . 24 cases of dysmenorrhvea relieved. 21 of 36 patients who hoped for pregnancy became pregnant(58.3%).The pregnant rate of patients with light uterin cavity adhesion was highest, followed by moderate uterin cavity adhesion, and there was no pregnancy in the cases of serious uterin cavity adhesion(χ 2=6 826, P =0 033). Conclusions Hysteroscope combined with B-ultrasound to treat uterin cavity adhesion is a preferable method. Pregnancy after operation was closely related to degree of uterin cavity adhesion.