宫腔镜子宫黏膜下肌瘤电切术疗效观察及米非司酮术前用药对手术操作的影响

[目的]分析宫腔镜下子宫肌瘤切除术(TCRM)治疗子宫黏膜下肌瘤的临床疗效及特点,并观察米非司酮术前用药对手术的影响.[方法]回顾性分析本院近三年来79例行TCRM患者的临床资料.[结果]本组79例黏膜下肌瘤患者均顺利完成手术.所有0型、Ⅰ型黏膜下肌瘤均一次切净,Ⅱ型中有6例未能一次切净而行分期手术,一次手术成功率为9...

Observation of the Efficacy of Transcervical Hysteromyomectomy under Hysteroscope for the Treatment of Submucous Myoma and the Effect of Mifepristone Premedication on Operation

[Objective] To analyze the clinical efficacy of transcervical hysteromyomectomy（TCRM） under hysteroscope for the treatment of submucous myoma and to observe the impact of mifepristone premedication on surgery. [Methods] Clinical data of 79 patients treated with TCRM in last 3 years in our hospital were ana- lyzed retrospectively. [Results] All 79 patients with submucous myoma underwent surgery successfully. All type-0 and type I submucous myoma were removed completely at the first time, and 6 type- Ⅱ submucosal myomas were not removed completely at the first time and underwent staging operation. The one-time surgical success rate was 92.4%（73/79）. Postoperative fever occurred in 5 cases. There was no uterine perforation, TURP syndrome and adjacent organ damage. At a month after surgery, 73 patients who completed the first surgery had normal menstrual cycle. Seven cases who required pregnancy had pregnancy in 5 cases（71.4%）. Fifteen patients who were not given mifepristone for contraindications（group B） had the same size of myoma as that of 42 patients who were given mifepristone（group C） （ P 〉0.05）. In group C, the myoma size decreased 3 months after mifepristone premedication （ P 〈0.05）. The operation time and blood loss in group C were less than those of group B（ P 〈0.05）. [Conclusion] TCRM for the treatment of uterine submucous myoma is safe and effective. Mifepristone premedication for the large myoma can decrease the tumor size and reduce the operation time and blood loss.