宫腔镜下Nd∶YAG激光手术治疗子宫纵隔

Hysteroscopic Treatment of the Uterine Septum by Nd:YAG Laser

目的探讨宫腔镜下Nd∶YAG激光手术治疗子宫纵隔的价值及安全性。方法对1994年5月至2002年10月期间施宫腔镜下Nd∶YAG激光手术治疗子宫纵隔203例患者的临床资料进行回顾性总结分析。结果宫腔平均深度7.3cm(7～9cm)。手术时间10～25min,平均13min,行一次Nd∶YAG激光手术后宫腔形态恢复正常182例,二次手术宫腔形态恢复正常21例。8例合并宫腔粘连者术中予粘连切除。术后大出血1例,术后大出血的发生率为0.49%。无子宫穿孔、感染等并发症发生。术后随访125例,99例妊娠,术后妊娠率为79.2%;其中84例足月分娩,正常分娩率为84.75%;术后流产率15.15%。结论宫腔镜下Nd∶YAG激光手术治疗子宫纵隔安全、简单、有效。

Objective To evaluate the value and safety of hysteroscopic treatment of the uterine septum by Nd∶YAG laser.Methods The clinical data of203cases with uterine septum treated by hyteroscopic Nd∶YAG laser resection from May1994to Oct2002are retrospectively reviewed.Results A tota l of182case operations were successfully done with one - step resection.From them21cases were with twice operations.The depth of uterine cavity was between7and9cm with the mean depth7.3cm and the operation time was between10and25min with the mean time 13min.There were no severe complications in operation,there was1massive hemorrhage case10days after operation and the bleeding rate was0.49%.After hysteroscopic septum resection,during follow - up period ranging from1to8years,eighty-four patients of99cases with pregnant had labored,with uncomplicated delivery rate was84.75%,miscarriage rate was15.15%.Conclusions Hysteroscopic treatment of the uterine septa by Nd∶YAG laser is a safe,simple,and effective procedure.