术中超声在宫腔镜子宫中隔电切术中的应用价值

目的探讨术中超声在宫腔镜子宫中隔电切术中的应用价值。方法经腹术中超声监测30例宫腔镜子宫中隔电切术,术中实时观察电切镜的位置和操作过程,监测切割深度,测量切割后宫底肌层的厚度。结果28例电切面到宫底浆膜面的厚度在正常范围内（0.8～1.5 cm）;2例切除过多,其中1例考虑存在子宫裂隙样小孔,及时在腹腔镜下修补。术后3个月经阴道三维超声示宫腔形态基本正常,5例可见0.4～0.7 cm的子宫中隔残留。结论术中超声具有快速、安全、精确及功用多的特点,可以对宫腔镜子宫中隔电切术予以实时指导和辅助,对正确的术中决策和减少手术并发症有很大的应用价值。

Value of Intraoperative Ultrasonography in Hysteroscopic Resection of the Uterus Septum

Objective To assess the value of intraoperative ultrasonography during the uterus septum resection under a hysteroscope. Methods The uterus septum resection was performed under the guidance of transabdominal ultrasonography by using a hystcroscope in 30 patients. The operative procedure and the position of the hysteroscope were monitored, and the depth of the dissection and thickness of the myometrium in the fundus uteri were measured with transabdominal ultrasound during the operation. Results The thickness between the incisal surface and serosal layer in the fundus uteri was within the normal limits in 28 cases. In 2 cases, the tissue was over-ectomized. The position of the urethral catheter balloon was correct in all of the 30 cases. Three months after the procedure, reexamination by transvaginal uhrasonography showed that the uterine cavity was normal in the patients. Conclusions Intraoperative uhrasonography is quick, safe and precise for monitoring uterus septum resection. It is valuable for establishing surgical strategy and reducing operative complications.