宫腔镜联合B超诊治子宫纵隔临床效果分析

Clinical effect of hysterocopy combined with B-ultrasonography on diagnosis and treatment of uterineseptum

目的 探讨宫腔镜与B超联合在诊治子宫纵隔中的作用。方法 对 4 8例子宫纵隔患者应用不同诊断方法及B超监视下宫腔镜子宫纵隔切开术 (TCRS)的效果进行回顾性分析。结果 术前诊断符合率 :子宫输卵管造影 (HSG) 5 2 .17% ;B超 78.5 7% ;宫腔镜联合B超 97.92 % ;术中情况 :B超监视下行TCRS术 4 5例 ,其中完全纵隔 9例 ,合并阴道纵隔 7例 ;不完全纵隔 36例。平均手术时间 (33.35± 11.76 )min ,出血 (14 .5 6± 5 .82 )ml。手术均一次完成 ,无子宫穿孔、脏器损伤等并发症发生 ;术后随访 :自然流产率由术前 87.36 %下降至术后 6 .2 5 % ,足月分娩率由术前 3.4 5 %上升至术后 5 0 .0 0 % ,均有显著性差异 (P <0 .0 0 1)。无分娩并发症发生。结论 宫腔镜与B超联合检查可明显提高子宫纵隔的诊断符合率 ;B超监视下行宫腔镜子宫纵隔切开术是一种安全、有效、理想的治疗方法 ,目前应作为首选治疗方法。

Objective: To evaluate the effect of the diagnosis and treatment in uterine septum by hysteroscopy and B-ultrasound.Methods:Forty-eight cases with uterine septum were retrospectively analyzed after examined in different ways and performed transcervical hysteroscopic resection of septum (TCRS) with being monitored by B-ultrasound.Results:Identical rates of diagnosis: before operation hysterosalpingography (HSG) 52.17%; B-ultrasound 78.57%; hysteroscopy with B-ultrasound 97.92%. During Operation TRCS 45 taken cases were monitored by B-ultrasound.Among them, 9 cases were complete uterine septum, 7 cases also were complete vagina septum, 36 cases incomplete uterine septum. The average time for operation was (33.35±11.76) min, The average blood loss was (14.56±5.82) ml. All operations were successful, no uterine perforation or intestinal injury occurred. Follow-Up after TCRS, the abortion rate decreased from 87.36% to 6.25%, delivery rate increased from 3.45%to 50.00%. There were highly significant difference (P<0.001) and no delivery complication occurrred. Conclusions:Usage of B-ultrasound in hysteroscopy can improve the identical diagnosis rate of uterine septum and make the operation safe and helpful. It should be recommended firstly.