超声引导自凝刀射频治疗子宫病变的临床价值

目的:提高超声引导自凝刀射频治疗功能失调性子宫出血(功血)、子宫肌瘤、宫颈息肉及宫颈糜烂的治愈率及有效率。方法:超声引导及监视下自凝刀通过宫颈、宫腔自然腔道。沿超声设计好的穿刺路线准确同插入肌瘤内或粘膜下肌瘤、宫颈息肉的蒂部;瘤体直径>3 cm者要先穿刺近浆膜处.待凝固完全后再退向近宫腔处;肌瘤直径≥4.5 cm者,术前均给予米非司酮12.5 mg/d,服用1~3个月以缩小瘤体。结果:所有手术患者手术过程均顺利.无一例子宫穿孔、大出血、肠管或膀胱损伤、宫颈管粘连等并发症。功血、粘膜下肌瘤、宫颈息肉、宫颈糜烂的治愈率均达100.00%;肌壁间及浆膜下肌瘤治愈率89.66%。结论:超声引导自凝刀射频治疗功血、子宫肌瘤、宫颈息肉及糜烂创伤小、操作简单、安全可靠.改进治疗方法后治疗效果满意。具有明确的临床价值。

Clinical significance of ultrasound-guided self-clotting cutter radiofrequency in the treatment of uterine disease

To improve the cure and effective rate in treatment of dysfunctional uterine bleeding , myoma ofuterus, cervical erosion and cervical polyp by ultrasound -guided self-clotting cutter .Methods: Ultrasound-guided self-clotting cutter puncture myoma, subserous myoma or stem of cervical polyp precisely across cervical canal and designed route . If myoma diameter was beyond 3 cm , self-clotting cutter punctured serous firstly, then backwarded to cervical canal after clotting thoroughly .The patients with myoma diameter ≥4.5 cm had taken mifepristone 12. 5 mg per day for 1-3 months to decrease myoma volume . Results: All operations were successful without complications such as uterine perforation, massive hemorrhage , bowel and bladder injuries , and cervical accretion. The cure rate of dysfunctional uterine bleeding , myoma of uterus, cervical erosion and cervical polyp was 100%; The cure rate of intramaral myoma and subserous myoma was 89.66%. Conclusion: Ultrasound-guided self-clotting cutter in treatment of dysfunctional uterine bleeding and myoma of uterus is easy and safe and has precise clinical efficiency after improving treatment method.