宫腔镜手术治疗剖宫产子宫切口瘢痕缺陷

目的探讨宫腔镜手术治疗剖宫产子宫切口瘢痕缺陷的有效性。方法总结分析2006年5月～2008年10月在我院确诊并行宫腔镜下矫形术的剖宫产切口瘢痕缺陷且术后均随访1年的12例患者临床资料。结果12例均手术顺利,未发生与手术相关并发症,术前9例经期延长者术后经期正常;术前1例经期延长伴不孕患者术后经期正常,但1年后仍未孕;术前1例经间期出血者症状消失;术前1例性交后出血者术后仍有症状。结论宫腔镜手术治疗剖宫产子宫切口瘢痕缺陷是微创、有效的治疗方法。     

宫腔镜电切术治疗子宫黏膜下肌瘤180例临床分析

摘要:目的:探讨宫腔镜电切术治疗子宫黏膜下肌瘤的临床疗效.方法:回顾性分析本院2005年1月至2009年1月宫腔镜下子宫黏膜下肌瘤电切术180例的手术情况及随访情况.结果:宫腔镜电切术,手术时间10 ～45 min,术中出血约10 ～60ml,无一例有感染、穿孔,术后随访12个月,患者的月经量及经期得到明显改善,治疗0...     

少腹逐瘀汤辅助宫腔镜手术治疗对子宫内膜息肉患者术后复发率的影响

目的 探讨少腹逐瘀汤辅助宫腔镜手术治疗对子宫内膜息肉患者术后复发率的影响。方法 选择2019年6月一2021年1月江苏省常州市武进中医医院收治的子宫内膜息肉患者124例为对象,根据治疗方法不同将患者分为对照组和试验组,每组各62例。对照组采用宫腔镜手术治疗,术后常规给予抗生素预防感染,并于下次月经后半周期即月经来潮后第15天,口服黄体酮胶囊,每次100 mg,每天2次,连续用药15d （1个疗程）。试验组在对照组基础上加用少腹逐瘀汤,连续服用4周。用药4周后评估患者相关指标,并完成12个月随访,比较两组症状消失时间、子宫内膜厚度、血浆黏度、纤维蛋白原、月经量,以及治疗后6、12个月的妊娠率及复发率。结果 试验组治疗后月经量增多、倦怠无力、五心烦热、面色晦暗及小腹疼痛症状消失时间均显著短于对照组（P<0.05）;两组治疗4周后子宫内膜厚度、血浆黏度、纤维蛋白原、月经量均显著低于本组治疗前（P<0.05）;试验组治疗4周后子宫内膜厚度、血浆黏度、纤维蛋白原、月经量均显著低于对照组（P<0.05）;随访12个月,试验组妊娠率显著高于对照组（P<0.05）;复发率显著低于对照组（P<0.05）。结论 宫腔镜手术后加用少腹逐瘀汤能显著缩短子宫内膜息肉患者症状消失时间,改善子宫内膜厚度及血液流变学水平,可调节患者月经量,提升患者妊娠率,降低复发率,值得推广应用。     

宫腔电切术治疗异常子宫出血84例分析

应用连续灌流宫腔电切镜 ,对 84例异常子宫出血患者进行宫腔电切术治疗。其中 ,子宫内膜切除术 2 3例 ,子宫肌瘤切除术 2 1例 ,肌瘤及内膜切除术 1 7例 ,子宫内膜息肉切除术 1 8例 ,宫腔异物取出术切除植入胎盘 5例。84例患者随访 78例 ,失访 6例。随访 1～ 1 8个月。结果 :78例术后月经均改善 ,1 6例 ( 2 0 .5% )无月经 ,30例( 38.5% )少量月经 ,32例 ( 41 .0 % )正常月经 ;1 4例痛经者 1 2例减轻。提示应用宫腔电切术治疗异常子宫出血 ,疗效高 ,效果满意     

Operative hysteroscopy intravascular absorption syndrome is more than just the gynecological transurethral resection of the prostate syndrome: A case series and literature review

ObjectiveOperative hysteroscopy intravascular absorption (OHIA) syndrome refers to fluid overload complications from operative hysteroscopies. Despite guidelines for safe operative hysteroscopies, instances of OHIA syndrome have been reported.Case reportWe reported three cases of OHIA syndrome. A 48-year-old female patient presented net irrigation fluid of 11,900 mL and developed severe metabolic acidosis, conscious disturbance, acute pulmonary edema, and unexpected intensive care unit admission. A 49-year-old female patient presented net irrigation fluid of 4500 mL and developed desaturation and acute pulmonary edema. A 45-year-old female patient presented net irrigation fluid of 2400 mL and developed hyponatremia, increased hilum lung marking, and prolonged postanesthesia care unit observation.ConclusionFor safety, clinicians should use isotonic electrolyte–containing distension media and bipolar electrosurgical instruments in operative hysteroscopies, and fluid status should be monitored closely, particularly at net and total irrigation amounts >3000 and > 8000 mL, respectively. Intrauterine pressure should also be minimized to reduce intravascular and intraperitoneal absorption.     

宫腔镜下子宫内膜息肉电切术的疗效分析

目的探讨宫腔镜下子宫内膜息肉电切术的临床效果。方法收集我院2017年8月至2018年8月治疗的80例宫腔镜下子宫内膜息肉电切术患者的临床资料进行回顾性分析。结果80例患者均顺利完成手术,术中术后无手术并发症发生。随访3、6、12月,76例术后恢复正常,复发4例,占5%。5例不孕症患者3例成功受孕,3例中度贫血患者均恢复正常。所有患者术后均有少量阴道流血,持续8~10天停止。结论宫腔镜电切术治疗子宫内膜息肉,定位准确,出血少,创伤小,复发率低,安全有效。     

Essure® hydrosalpinx occlusion prior to IVF-ET as an alternative to laparoscopic salpingectomy

Objective

To investigate the success rate of proximal tubal occlusion with Essure^® devices in subfertile women with unilateral or bilateral hydrosalpinx and to observe the results of subsequent treatment with IVF-ET and/or frozen embryo transfer.

Study design

Prospective, single-arm, clinical study in 20 women with unilateral or bilateral hydrosalpinges (all visible on transvaginal ultrasound) due to undergo IVF-ET and/or frozen embryo transfer. In all patients, laparoscopy was considered to be contraindicated due to extensive pelvic adhesions.

Result(s)

In all patients the Essure^® devices were placed in an ambulant setting without any complications. Proximal tubal occlusion was confirmed by hysterosalpingography in 19 out of 20 patients (95%) and in 26 of 27 treated tubes (96%). After 45 embryo transfer procedures in 19 patients, 18 pregnancies with 12 live births, 6 miscarriages and 1 immature delivery (probably related to cervical insufficiency leading to chorioamnionitis and subsequent rupture of the membranes) were observed.

Conclusion(s)

Essure^® devices are effective in inducing proximal tubal occlusion in subfertile patients with hydrosalpinges. After artificial reproductive treatments a cumulative live birth rate per patient of 63% and a cumulative live birth rate per transfer of 27% were achieved. The latter was related to the large proportion of patients with severe endometriosis.     

腔镜技术治疗输尿管狭窄的护理配合

目的探讨腔镜技术治疗输尿管狭窄的手术护理配合。方法对2007年6月～2009年6月我院采用腔镜技术治疗输尿管狭窄165例患者的手术配合资料进行回顾分析。结果手术配合默契,效果满意,术中没有严重的并发症发生。结论护士熟悉手术程序,掌握仪器设备的操作要点,灵活有效的配合是保证手术顺利完成的关键。