宫腔镜电切术前负压吸宫及术后电熨联合治疗异常子宫出血

目的：探讨宫腔镜电切除术前负压吸宫及术后电熨联合治疗异常子宫出血的疗效及预后。方法：选择有手术指征的异常子宫出血患者87例，采用被动式连续灌流宫腔电切镜行子宫内膜切除40例，肌瘤切除33例,肌瘤及内膜切除3例，息肉切除5例，息肉及内膜切除6例。结果：手术均顺利完成。术后随访3－11个月，总有效率96．6％，其中单纯子宫肌瘤及息肉切除术者，术后月经均减少或恢复正常；49例子宫内膜切除术同时切除肌瘤、息肉者，57．1％无月经，32．7％月经减少，4．1％月经正常，对痛经治愈率为100％，59列术前贫血者术后58例恢复正常，纠正贫血有效率为98．3％。术后并发症为3．4％，宫腔粘连并积血1例，月经无改善2例。结论：宫腔镜电切术前负压吸宫可薄化子宫内薄，电切术后滚球电极电熨切面可灭活由于电切深度不够或宫角处遗漏的内膜，与宫腔镜电切术联合应用可提高手术成功率，减少术后复发率，长期疗效尚待观察。

Hysteroscopic Electric Resection with Preoperative Vacuum Extraction and Postope rative Electrocoagulation for Abnormal Uterine Bleeding

Objective:To evaluate the effectiveness and prognosis of hysteroscopic electric resection with preoperative vacuum extraction and postoperative electrocoagulation in abnormal uterine bleeding (AUB). Method:87 women with AUB who had surgical signs were treated with a continuous flow resectoscope.Among them,40 cases received hysteroscopic electric resection of trancervical resection of endometrium (TCRE) 33 cases received myomas resection,3 cases received myomas and endometrium resection,5 cases received polyps resection,6 cases received polyps and endometrium resection.all cases were used preoperative vacuum extraction and postoperative electrocoagulation and were followed for 3 to 11 months.The observed parameter included the postoperative menstruation and the prognosis.Results:The total effective rate of menstrual flow ameliorated was 96.6%.All the women with dysmenorrhea had relieved pain after surgery (100%).58 out of 59 cases with anemia has been recovered after surgery(98.3%).The complication incidency of surgery was 3.4%.Conclusions:The preoperative vacuum extraction can make the endometrium thinner.The post operative electrocoagulation can destroy the endometrium where the hysteroscopic electric resection can't reach,Ours combinated therapy can improve the successful rate of surgery,as well as decrease the rate of postoperative reaccurency,Its long-term efficiancy is get to be identified.