宫腔镜联合腹腔镜诊治子宫畸形94例临床分析

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1、宫腔镜联合腹腔镜诊治子宫畸形94例临床分析作者：韩毓,胡春艳，洪顺家单位：1•海南省海口市琼山区府城医院妇产科,2.海南省人民医院妇科，海南海口570100;3.中山大学附属第二医院，广东广州510120【摘要】目的：探讨宫腔镜联合腹腔镜诊治子宫畸形的价值。方法：回顾性分析94例经宫、腹腔镜联合诊治的子宫畸形病例临床资料，1组48例行腹腔镜和宫腔镜分期检查及手术，2组46例行腹腔镜和宫腔镜同期检查及手术。结果：94例中77例为不全纵隔子宫，12例为完全纵隔子宫，4例单角子宫合并残角子宫，1例双子宫。宫腔镜联合腹腔镜检查同时可手术解除导致不孕或不育的因素（如盆腔粘连、多囊

2、卵巢综合征、子宫内膜异位症并矫正子宫畸形等），超声、子宫输卵管造影和宫腔镜等检查均有一定的误诊率。1组患者手术顺利，无并发症出现，住院2〜9d,平均5d,2组患者中2例在宫腔镜手术中出现宫底电击小穿孔，在腹腔镜下行创口缝合术，住院2〜7d,TO4d0结论:宫、腹腔镜联合检查并手术对于疑有子宫畸形合并不孕不育的患者是理想的诊治方法。【关键词】宫腔镜;腹腔镜;子宫畸形Combineddiagnosisofuterinema1formationwithhysteroscopyandlaparoscopy:94casesanalysisHANYul,HUChunyan2,HON

3、GShunjia3(IDepartmentofGynaecologyandObstetrics,FuchengHospitalinQiongshanDisctrict,2DepartmentofGynecology,People5sHospitalHaikou570100,China;3The2ndHospitalAffiliatedtoZhongshanUniversityGuangzhou510120,China)[ABSTRACT]Objective:Toexplorevalueofcombineddiagnosisofuterinemalformationwit

4、hhysteroscopyandlaparoscopy.Methods:Retrospectivelyanalyzedclinicdataof94caseswithuterinemalformationdiagnosedbyhysteroscopyandlaparoscopy.48casesingroup1wereexaminedandtreatedbysurgeryunderhysteroscopyandlaparoscopyatdifferentstage,while46casesingroup2wereexaminedandtreatedbysurgeryatth

5、esamestage・Results:77outof94caseshadincompletemediastinaluterine,12hadcompletemediastinaluterine,4hadunicornuateuterusaccompaniedwithrudimentaryhornofuterus,1haddoubleuterus.Riskfactorsleadingtosterilityandinfertilitysuchaspelvicadhesion,polycysticovarysyndrome,endometriosis,anduterinema

6、lformationwereremovedafterexaminationandsurgeryunderhysteroscopyandlaparoscopy.Misdiagnosisoccurredasdiagnosingwithultrasound,hysterosalpingographyandhysteroscopy.Patientsingroup1hadsuccesssurgerywithoutcomplication,with2-9d,average5dcourseinhospital;while2casesingroup2hadsmallperforatio

7、natuterinebottomduetoelectricshock,andhadtraumatonesiswith2~9d,average4dcourseinhospita1.Conclusion:Combinedexaminationwithhysteroscopyandlaparoscopyisanidealdiagnosismethodforinfertileandsterilepatientswithsuspiciousuterinema1formation.[KEYWORDS]Hysteroscopy;Laparoscopy;