宫腔镜子宫粘膜下肌瘤切除术80例报告

目的:探讨宫腔镜电切术治疗子宫粘膜下肌瘤的疗效及安全性。方法:回顾分析2010年1月至2011年10月80例粘膜下子宫肌瘤患者的临床资料,其中0型26例,Ⅰ型34例,Ⅱ型20例,均行宫腔镜手术,观察患者术中情况以及术后效果、妊娠、后续药物治疗等情况。结果:80例手术均顺利完成,0型、Ⅰ型及12例Ⅱ型粘膜下子宫肌瘤均一次切除,8例Ⅱ型粘膜下肌瘤一次切除70%～80%。2例术中出血;1例术后感染;2例术后宫腔粘连。75%的残留肌瘤联合米非司酮治疗消退或脱落,不孕患者受孕率63.6%。结论:治疗粘膜下子宫肌瘤,宫腔镜电切术是较好的选择。严格掌握手术指征,提高手术质量,严密B超监测,残留肌瘤联合米非司酮治疗是提高术后疗效及手术安全性的有效措施。

Hysteroscopic surgery for 80 cases with submucosal myoma of uterus

Objective:To study the clinical effects and safety of hysteroscopic surgery for submucosal uterine myoma.Methods:Eighty cases of uterus submucosal myoma were treated with hysteroscopic surgery from Jan.2010 to Oct.2011,including 26 cases of Type 0,34 cases of typeⅠ,20 cases of typeⅡ.The operation details,postoperative effects,postoperative pregnancy,postoperative medicine treatments were analyzed retrospectively.Results:All operations were conducted successfully,all cases of type 0 and typeⅠ,and 12 cases of type Ⅱsubmucosal myoma were resected completely,8 cases of type Ⅱ submucosal myoma were resected partly(70%~80%).2 cases of intra-operative hemorrhage,1 case of infection and 2 cases of intrauterine adhesion occurred.75.0% of residual myoma disappeared after Mifepristone therapy.The postoperative pregnancy rate of infertile patients was 63.6%.Conclusions:Hysteroscopic surgery is the preferred way for the treatment of submucosal myoma of uterus.Proper selection of indication,improvement of surgery quality,strict ultrasound monitoring and combined therapy of Mifepristone are important to guarantee the effectiveness and the safety of operation.