宫腔镜和经腹行子宫纵隔切除术的疗效研究

目的探讨宫腔镜和经腹行子宫纵隔切除术手术的疗效及诊断和治疗情况。方法回顾性分析我院2008年1月～2010年12月住院的85例子宫纵隔患者的临床资料，61例宫腔镜行子宫纵隔切除术，24例经腹行子宫纵隔切除术。所有患者随访6～12个月观察妊娠和怀孕情况，比较手术出血量、手术时间、住院时间、术后并发症情况、自然流产率。结果两种手术方式比较，宫腔镜下纵隔电切术手术时间平均（54．9±16．7）min，术中出血（25．5±9．4）mL，住院时间（3．5±0．4）d；经腹手术时间平均（70．4±23．5）min，术中出血（65．2±13．8）mL，住院时间（6．8±1．5）d，两组相比差异有统计学意义（P〈0．05）。75例患者术后按患者1、3、6个月。随访81例，随访率为95．29％，失访4例。患者手术前后比较，自然流产率均降低，分娩率均提高，均有显著性差异（P〈0．05）。结论子宫纵隔传统的开腹子宫切除术逐渐被宫腔镜下手术取代；但对完全性子宫纵隔患者，传统的手术方法仍具有优势。

Efficacy comparison on hysteroscopy and trans-abdominal resection for uterine septum

Objective To discuss the effect of hysteroscopy and trans-abdominal resection for uterine septum. Methods The information of 85 cases with uterine septum from Jan 2008 to Dec 2010 were respectively analyzed. 61 were performed operation under hysteroscopy,while the other 24 cases were given trans-abdominal resection for uterine septum. All the cases were followed up for 6-12 months. Their intraoperative blood loss, operation time, hospitalization time, postoperative complications and spontaneous abortion rate were compared. Results The operation time were （54.9±16.7） min in hysteroscopy group and （70.4±23.5） min in trans-abdominal operation group;the intraoperative blood loss were （25.5±9.4） mL in hys- teroscopy group and （65.2±13.8） mL in trans-abdominal operation group; the hospitalization time were （3.5±0.4） d in hys- teroscopy group and （6.8±1.5） d in trans-abdominal operation group. The difference between two groups had statistical sig- nificance （P 〈 0.05）. 81 cases were followed up for 1,3,6 months. The follow-up rate was 95.29%. 4 cases were lost of follow-up. Patients＇ spontaneous abortion rate was decreased after operation. The delivery rate was improved. The differ- ence before and after operation had Statistical significance （P 〈 0.05）. Conclusion The traditional trans-abdominal opera- tion is gradually substituted by hysteroscopy operation, but it still has advantage in complete uterine septum.