CAJ | 학술논문

目的：探讨宫腔镜手术治疗完全性子宫中隔合并不孕的价值。方法2008年1月～2011年12月对22例完全性子宫中隔合并不孕分别施行腹腔镜监视下宫腔镜子宫中隔电切术（14例）或B超监护下宫腔镜子宫中隔电切术（8例）。均自宫颈内口上方用针状电极完全划开中隔，直至中隔基底部位。结果除1例宫、腹腔镜联合手术因中隔过厚行2次宫腔镜子宫中隔电切术外，余21例手术均顺利。术后2个月复查宫腔镜宫腔形态均恢复正常。术后随访21例，13例妊娠，妊娠率61．9％（13/21），其中足月单胎分娩10例（自然分娩6例，剖宫产4例），双胎孕35周早产自然分娩1例，自然流产2例（流产率15．4％，2/13）。术后妊娠时间5～21个月，平均11．3月。结论腹腔镜或B超监视下宫腔镜子宫中隔电切术治疗完全性子宫中隔合并不孕安全、有效。
목적：탐토궁강경수술치료완전성자궁중격합병불잉적개치。방법2008년1월～2011년12월대22례완전성자궁중격합병불잉분별시행복강경감시하궁강경자궁중격전절술（14례）혹B초감호하궁강경자궁중격전절술（8례）。균자궁경내구상방용침상전겁완전화개중격，직지중격기저부위。결과제1례궁、복강경연합수술인중격과후행2차궁강경자궁중격전절술외，여21례수술균순리。술후2개월복사궁강경궁강형태균회복정상。술후수방21례，13례임신，임신솔61．9％（13/21），기중족월단태분면10례（자연분면6례，부궁산4례），쌍태잉35주조산자연분면1례，자연유산2례（유산솔15．4％，2/13）。술후임신시간5～21개월，평균11．3월。결론복강경혹B초감시하궁강경자궁중격전절술치료완전성자궁중격합병불잉안전、유효。
Objective To explore the clinical value of hysteroscopic surgery for complete septate uterus complicated with primary or secondary infertility . Methods We retrospectively evaluated 22 infertile patients undergoing hysteroscopic resection of septate uterus from January 2008 to December 2011.Of the 22 cases, 14 cases underwent hysteroscopic metroplasty under laparoscopy and 8 cases under ultrasonography .The septum was fully cut from the internal ostium of cervix to the fundal uterus by needle electrode . Results All patients underwent hysteroscopic metroplasty successfully without serious complications except for one case requiring the second operation due to the thick septate uterus .The follow-up of 2 months after the surgery showed normal uterine cavity under hysteroscopy.A total of 21 cases were followed up and 13 cases were found pregnant with a pregnancy rate of 61.9% (13/21), including 10 cases of full-term single birth (natural delivery:6 cases;cesarean delivery:4 cases), 1 case of natural delivery after 35 gestational weeks and 2 cases of spontaneous abortion (abortion rate:15.4%, 2/13).Gestation started 5-21 months after the surgery (average, 11.3 months). Conclusion Hysteroscopic metroplasty combined with laparoscopy or ultrasonography is a safe and effective procedure for the treatment of infertile patients with septate uterus .