March C M, Israel R, March A D
Am J Obstet Gynecol. 1978 Mar 15;130(6):653-7. doi: 10.1016/0002-9378(78)90322-8.
Sixty-six patients who had the presumptive diagnosis of Asherman's syndrome underwent hysteroscopic evaluation and treatment. In 65 patients, hysteroscopy was performed on an outpatient basis under local anesthesia. In all but five patients, complete lysis of adhesions was accomplished during the initial hysteroscopy. Uterine perforation occurred in two of the 66 patients. The extent of the intrauterine adhesions correlated with the patients' presenting menstrual patterns, but not with prior hysterosalpingography. Of the patients who have completed surgical and hormonal therapy, 98 per cent have normal spontaneous menses. Follow-up examination of the endometrial cavity was normal in 32 of 34 patients. Seven of ten patients who wished to conceive and who had no other infertility factors have done so. The pregnancies have been uncomplicated. Hysteroscopy is the method of choice to diagnose, classify, treat, and follow-up patients with Asherman's syndrome.
66例初步诊断为阿谢曼综合征的患者接受了宫腔镜评估和治疗。65例患者在局部麻醉下于门诊进行了宫腔镜检查。除5例患者外，其余患者在初次宫腔镜检查时均实现了粘连的完全松解。66例患者中有2例发生子宫穿孔。宫腔粘连的程度与患者的月经表现相关，但与既往子宫输卵管造影无关。在完成手术和激素治疗的患者中，98%月经自然恢复正常。34例患者中有32例子宫内膜腔的随访检查结果正常。10例希望怀孕且无其他不孕因素的患者中有7例已成功受孕，且妊娠过程均无并发症。宫腔镜检查是诊断、分类、治疗和随访阿谢曼综合征患者的首选方法。
