宫腔镜电切术治疗宫颈良性病变204例临床分析

目的探讨宫腔镜下宫颈电切术对宫颈良性病变的治疗效果。方法对204例采用电视宫腔镜行电切术治疗宫颈良性病变患者的临床资料进行回顾性分析。结果204例患者一次性治愈率为98.53%,5例(2.45%)患者出现术后出血。结论宫腔镜电切术是治疗宫颈良性病变的一种安全、高效、经济的方法。     

2006—2008年我院口服降糖药应用分析

目的探讨宫腔镜下宫颈电切术后口服杏香兔耳风片治疗重度慢性宫颈炎的临床效果。方法对2005年7月—2008年7月在我院行宫腔镜下宫颈电切术355例患者进行回顾性分析。结果宫腔镜下宫颈电切术后随访2月,治愈率达98%以上。结论宫腔镜下宫颈电切术治疗重度慢性宫颈炎具有治愈率高,出血少,宫颈整形效果好等优点,术后口服杏香兔耳风片有减轻术后出血及排液的作用。     

宫腔镜电切术治疗肥胖患者异常子宫出血的疗效

目的:探讨宫腔镜电切术治疗肥胖患者子宫异常出血的疗效。方法:应用美国Stryker公司生产的27F被动式连续灌流宫腔电切镜,对82例子宫异常出血患者进行宫腔镜电切手术治疗,其中功能性子宫出血46例,子宫内膜息肉36例。结果:82例均1次顺利完成手术,手术时间15~45min,术后随访5~36个月,月经改善率96.5%,其中无月经18.8%,月经减少45.4%,月经正常31.6%。结论:宫腔镜电切治疗肥胖患者异常子宫出血是一种安全、有效的手术方式,围手术期评估充分、准备完善,可降低此类患者的手术及麻醉风险。     

Hysteroscopic treatment of the uterine septum: A clinician’s experience

Objective: I reviewed my experience with the diagnosis and hysteroscopic treatment of uterine septa. Study Design: This article is a retrospective review of cases from 1992-1999. A septate uterus was diagnosed in a total of 40 patients, and all were treated by hysteroscopic resection. Results: The rate of preoperative pregnancy loss was 77.4%, and the uncomplicated delivery rate was 6.5%. After hysteroscopic septum resection 21 patients reported a total of 22 pregnancies with an 18.2% miscarriage rate and a 77.3% uncomplicated delivery rate. Conclusion: Hysteroscopic treatment of uterine septa is a safe, simple, and effective procedure. It can be used for all types of uterine septa, it attains optimal obstetric outcomes, and it should be undertaken whenever a uterine septum is diagnosed. (Am J Obstet Gynecol 2000;182:1414-20.)     

经尿道射精管切开术治疗远端射精管梗阻引起的精囊囊肿

目的:进一步探讨由于射精管梗阻引起的精囊囊肿的治疗。方法:采用精液分析(包括精液的量、pH值、果糖的测定)、经直肠指检和B超检查的方法。于2005年11月～2006年12月,12例诊断为射精管梗阻引起的精囊囊肿[(2.3±1.1)cm]患者,采用经尿道电切镜切开、切除梗阻的射精管,直到见到有乳白色的精液排出的方法治疗。结果:12例精囊囊肿患者术后1、3、12个月复查囊肿明显缩小[(1.0±0.8)cm,P<0.05]。没有发现明显的并发症。10例在术后3个月复查精液时检出活精子,12例精液量手术前后分别为(1.6±0.8)ml、(3.5±1.2)ml(P<0.05)结论:经尿道电切术治疗射精管梗阻引起的精囊囊肿是一种简单、有效的方法。     

LNG-IUS、地屈孕酮及屈螺酮炔雌醇对子宫内膜息肉患者TCRP术后复发的影响

目的比较左炔诺孕酮缓释系统(LNG-IUS)、地屈孕酮及屈螺酮炔雌醇对子宫内膜息肉患者宫腔镜子宫内膜息肉电切术(TCRP)术后复发的影响。 方法将93例子宫内膜息肉患者分为地屈孕酮组、屈螺酮炔雌醇组和LNG-IUS组,各组31例。比较3组子宫内膜厚度、月经失血图(PBAC)评分、血清性激素水平、不良反应及复发情况。 结果术后3、6、12个月,子宫内膜厚度、PBAC评分LNG-IUS组低于地屈孕酮组和屈螺酮炔雌醇组,术后6、12个月屈螺酮炔雌醇组低于地屈孕酮组(P＜0.05)。术后12个月,LNG-IUS组促卵泡刺激素、雌二醇低于地屈孕酮组和屈螺酮炔雌醇组,且屈螺酮炔雌醇组低于地屈孕酮组(P＜0.05)。Kaplan-Meier法分析显示,LNG-IUS组累积无复发率高于地屈孕酮组和屈螺酮炔雌醇组(P＜0.05)。 结论LNG-IUS能更好抑制子宫内膜息肉患者TCRP术后复发,效果显著,安全可靠。     

腺性膀胱炎47例临床治疗分析

目的 探讨腺性膀胱炎的治疗方法。方法 本组47例，均经膀胱镜检查，发现滤泡样变25例，乳头瘤样变16例，慢性炎症4例，无明显改变2例。经尿道电切术后加单次表阿霉素(EPI)膀胱内灌注治疗42例，保守治疗5例。定期膀胱镜检查，并行组织学观察。结果 随访12～72个月，平均24个月。43例痊愈，膀胱粘膜逐渐恢复移行上皮覆盖。3例复发，1例转变为腺癌，行膀胱全切。结论 病变轻微的腺性膀胱炎者通常采用药物治疗；病变广泛者或乳头瘤型者首选经尿道电切术后加膀胱内化疗药物灌注则有助于膀胱上皮的组织学转归。     

Residual uterine septum of less than 1 cm after hysteroscopic metroplasty does not impair reproductive outcome

The objective of this study was to ascertain if incomplete correctionleaving a residual uterine septum of 1 cm affects fertilityoutcome. Reproductive outcome in 17 women with a residual septumof between 0.5 cm and 1 cm after hysteroscopic metroplasty wascompared to that in 51 women with no residual septum or oneof <0.5 cm. Septal lysis was performed with microscissorsor resectoscope. One month after operative hysteroscopy, abdominalultrasono-graphy was performed on all the women and those witha residual septum of >1 cm then underwent a second operativehysteroscopy to complete the lysis. The cumulative pregnancyand birth rates were calculated and the curves compared usingthe log-rank test. The cumulative 18 month probability of becomingpregnant was 44.5% in the patients with residual septum and52.7% in those with no residual septum (not significantly different),and the cumulative 18 month probability of giving birth to achild was 27.5 and 36% respectively (also not significant).The presence of a residual uterine septum of between 0.5 and1 cm as shown by ultrasonography appears not to worsen the reproductiveprognosis compared with that in women in whom the septum hasbeen completely or almost completely corrected.     

复方芬太尼合剂在宫腔镜电切术中的应用

目的 :观察复方芬太尼合剂在宫腔镜电切术中的镇痛疗效。方法 :对 5 5例子宫粘膜下肌瘤、宫内膜息肉、子宫不全纵隔、宫颈管息肉患者行宫腔镜电切前 ,将芬太尼 1μg/kg、氟哌利多 60 μg/kg、东莨宕碱 3 5 μg/kg,加入注射用水 10ml稀释。静脉缓慢推注 ,同时将 2 %利多卡因 3ml宫颈注射 ,观察麻醉效果、宫口松驰情况 ,记录推药前 ,推药后 3min ,手术时 ,手术后 5minBp、P、SPO2 等参数。结果 :复方芬太尼合剂应用于宫腔镜电切术 ,镇痛、镇静效果明显 ,有效率达 10 0 % ,处于清醒状态 ,血压心率无明显变化。结论 :复方芬太尼合剂静脉麻醉是宫腔镜下行电切术的适宜麻醉方法之一 ,可达到无痛的良好效果。