宫腔镜电切术治疗子宫黏膜下大肌瘤65例疗效分析

目的探讨宫腔镜手术治疗子宫黏膜下大肌瘤的治疗效果及安全性。方法直径≥5cm子宫黏膜下肌瘤65例,其中0型肌瘤6例,Ⅰ型19例,Ⅱ型40例;子宫黏膜下肌瘤单发36例,多发29例;均在全身麻醉下行宫腔镜下电切术治疗。结果本组手术过程均顺利,主要肌瘤完全切除;0、Ⅰ、Ⅱ型肌瘤手术时间、术中出血量及术后血红蛋白水平比较差异无统计学意义（P〉0.05）;0型肌瘤手术中膨宫液用量较Ⅰ、Ⅱ型肌瘤少（P〈0.05）;无严重并发症发生;随访10个月~5a,月经过多控制成功率90.9%,总满意率92.3%,无复发。结论宫腔镜电切术治疗子宫黏膜下较大肌瘤切除完全、创伤小、并发症少。

Therapeutic effect of hysteroscopic transcervical resection on large submucous myoma in 65 cases

Objective To investigate the effect and safety of hysteroscopic transcerveical resection of larger myoma. Methods Sixty-five patients with large submucous myoma ≥5 cm in diameter included 6 cases of type 0, 19 cases of type I and 40 cases of type II. Single myoma was in 36 cases and multiple myoma in 29. All patients underwent hysteroseopic surgery under general anesthesia. Results The operation was completed successfully in all patients, and the dominant myoma was removed. There were no significant differences in the operation duration, intraoperative blood loss and haemoglobin level among type 0, I and ]] myomas （P〉0.05）. The used volume of cavity-distension media was less in type 0 myoma than that in type I and II myomas （P〈0.05）. No serious complications occurred. During the followup survey for 10 months to 5 years, the success rate of menorrhagia controlling was 90.9%, and the total satisfactory rate 92.3% . There is no myoma recurrences in all patients. Conclusions Hysteroscopic transeervical resection can remove large submueous myoma completely, with small trauma and few complications.