子宫内膜切除术治疗月经过多患者的临床分析

目的:总结子宫内膜切除术治疗月经过多的手术指征、手术方法、预后及体会。方法:应用连续灌流宫腔电切镜,对400例手术指征为保守治疗无效的月经过多、无生育要求、合并粘膜下肌瘤直径≤5cm的病人行子宫内膜切除术,其中72例同时切除子宫肌瘤,术中子宫穿孔3例。术后随访3个月~4年者366例,其中13例因异常出血行第二次手术。结果:16例因手术失败切除子宫,其余350例月经均有所改善,手术成功率95.6%。术后146例(41.7%)无月经,119例(34.0%)月经为滴状,85例(24.3%)经血明显减少,原有痛经者78.3%的痛经症状消失或减轻。术后远期合并症有异常出血22例,宫腔积血5例,子宫腺肌病4例。结论:子宫内膜切除术可减少或停止月经,减轻痛经,同时切除肌瘤,疗效较满意。

Analysls of outcomes of transcervical resection of endometrium in 400 cases with menorrhagia.

Objective:To report the efficacy and outcomes of transervical resection of endometrium(ECRE)in treatment of menorrhagia.Methods:Among them,72 patients with submucous uterine myoma less than 5 cm in diameter had their myoma resected simultaneously,366 cases were followed up postoperatively for 3 months to 4 years.13 of them had a second operation.Results:TCER was performed successfully except 16 cases,giving a success rate of 95.6%.Three cases sustained uterine perforation.During follow-up,146 cases(41.7%)became amenorrhea,119(34.0%)had only spotting.The remaining 85(24.3%)had normal periods,78.3% who previously had dysmenorrhea had relieved their pain.Long-term complications were recurrent abnormal uterine bleeding of 22 cases,hematometra 5 cases and adenomyosis 4 cases.Conclusion:TCRE is an effective procedure in treating menorrhagia and small submucous uterine myoma.