宫腔镜电切术治疗子宫黏膜下肌瘤168例分析

目的探讨宫腔镜电切治疗子宫黏膜下肌瘤的临床疗效及手术安全性。方法2000年1月～2004年12月168例子宫黏膜下肌瘤根椐肌瘤类型,选择不同的电切方式进行切割,对出血严重、年龄大于45岁的患者同时行子宫内膜电切。结果168例子宫黏膜下肌瘤宫腔镜电切术均成功完成,手术时间5～65min,（27.6±12.1）min;术中出血量8～50ml,（40.1±10.2）ml。子宫穿孔2例,低钠血症3例,术后一过性发热5例。168例随访1～24个月,（16.0±5.3）月,术后月经改善情况满意率95.2%（160/168）。结论宫腔镜电切治疗子宫黏膜下肌瘤是一种微创、安全、有效的方法。术前预处理,严格掌握手术指征,术中严密监测及娴熟手术操作,是预防并发症的基本措施。

Hysteroscopic Resection for Submucous Uterine Myoma: Report of 168 Cases

Objective To investigate the efficacy and Methods From January 2000 to December 2004, a total of 168 hysteroscopy in our hospital. According to the type of the myomas, safety of hysteroscopic treatment for submucous uterine myoma. women with submucous leiomyoma of the uterus were treated by electro-resection was performed in different ways. For the patients with massive hemorrhage or older than 45 years, the endometrium was resected during the operation. Results The operation was completed in all the cases within 5 to 65 minutes mean, （27.6±12. 1 ） minutes]. The mean blood loss was （40. 1 ± 10. 2） ml （8 - 50 ml）. After the surgery, 2 patients developed uterine perforation, 3 had hyponatremia, and 5 showed transient fever. Among the patients, 160 （95. 2% ） were satisfied with the outcomes of the surgery. Conclusions Transcervical electro-resection by hysteroscopy is a minimally invasive, safe, and effective method for submucous uterine myoma. Preoperative preparation, strict indication criteria, and intraoperative monitor are three key points to avoid operation-related complications.