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本文报道了1例罕见的子宫隔膜,患者继发不孕2年,于7年前孕40d自然流产,B超检查发现子宫纵隔,未刮宫,有痛经史。宫腔镜术中发现宫颈外口上约2·5cm处有隔,基本呈水平位,其上方与纵向的子宫纵隔相连,诊断为宫颈横膈和子宫纵隔。有关宫颈横膈尚未见文献报道,足以证明其罕见程度。子宫纵隔畸形可分为先天性和后天性两种,后者宫腔的中央性粘连带将原本正常的宫腔分割成为两个腔,不对称,但也有十分对称者,酷似先天性子宫纵隔。宫颈隔膜也应与后天性的宫腔粘连相鉴别。宫腔粘连的病因有子宫创伤、感染及遗传因素等。本例无宫腔操作史,可排除子宫创伤所致的宫腔粘连,但有自然流产史,存在宫腔感染的可能性,患者虽有子宫纵隔和继发不孕等宫腔粘连综合征的典型症状,但其宫腔内水平位隔膜应与宫腔粘连相鉴别。
This article reports a case of rare uterine septum, secondary to infertility in patients 2 years, spontaneous abortion 40 days after 7 years ago, B-ultrasound found uterine mediastinal, not curettage, history of dysmenorrhea. Hysteroscopy found around the cervix on the mouth about 2.5 cm at intervals, the basic level, the top of the vertical uterine mediastinal connected to the diagnosis of the cervical diaphragm and uterine mediastinal. The cervical diaphragm has not been reported in the literature, sufficient to prove its rare level. Uterine mediastinal malformations can be divided into two kinds of congenital and acquired, the latter central uterine adhesions will be the original normal uterine cavity split into two cavities, asymmetric, but also very symmetrical, resembles the congenital uterine mediastinal. Cervical septum should also be differentiated from acquired intrauterine adhesions. The causes of uterine adhesions uterine trauma, infection and genetic factors. In this case no history of uterine operation to exclude uterine adhesions caused by uterine trauma, but the history of spontaneous abortion, the possibility of intrauterine infection, although the uterine mediastinum and secondary infertility and other intrauterine adhesions syndrome Typical symptoms, but the intrauterine level of the diaphragm should be differentiated and intrauterine adhesions.