宫腔镜治疗结核引起的重度宫腔粘连14例分析

目的 探讨宫腔镜治疗由子宫内膜结核引起的重度宫腔粘连(IUA)的安全性和有效性。方法 回顾性分析1998年1月～2004年5月间该院行经宫颈宫腔粘连切除术(TCRA)治疗由结核所致的14例重度IUA患者的临床资料。结果 全部手术均在B超或B超联合腹腔镜监护下完成，术中出现子宫穿孔2例，术后患者宫腔形态基本恢复正常。平均随访38个月，所有患者均再次形成重度IUA，无1例妊娠。结论 宫腔镜治疗IUA是安全的，但由子宫内膜结核引起的重度IUA，经TCRA及相关治疗后预后很差。

Analysis on 14 cases of intrauterine adhesions due to endometrial tuberculosis treated with hysteroscopy

To evaluate the effectiveness and safety of hysteroscopic lysis for treatment of severe intrauterine adhesions (IUA) due to endometrial tuberculosis. To analyze and summarize the clinical practices of 14 patients with severe IUA due to endometrial tuberculosis who had been treated by transcervical resection of adhesions (TCRA) from January, 1998 to May, 2004. All cases were under B-ultrasound and / or laparoscopic monitoring, 2 uterine perforation occurred, which were treated in time. Adequate uterine cavity obtained in all cases after operation. But severe intrauterine adhesions recurred in all patients and no pregnancy. Conclusions] The treatment of IUA by hysteroscopy is safe. Severe IUA caused by endometrial tuberculosis, unlike other causes, carry a very poor prognosis.