摘要
目的 应用宫腔镜手术治疗各种类型的粘膜下子宫肌瘤 ,并评价该手术的疗效及其安全性。方法 因异常子宫出血经宫腔镜联合B超检查 ,诊断为粘膜下子宫肌瘤 ,而行经宫颈子宫肌瘤切除术或同时行经宫颈子宫内膜切除术者 78例 ,粘膜下子宫肌瘤中 0型 2 2例 ,Ⅰ型 30例 ,Ⅱ型 2 6例 ,术后随访 3～ 33个月。根据术后月经改善情况、剩余肌瘤有无增长、是否再次手术等将疗效分为满意和不满意。结果 应用宫腔镜手术治疗粘膜下子宫肌瘤 ,术后满意率为 96 15 % ,0型、I型术后满意率达 10 0 % ,10例要求生育者 4例妊娠 ,3例已分娩。Ⅱ型子宫肌瘤中切除范围≥ 70 %者 9例 ,术后随访残余肌瘤不再增长。全部手术无一例并发症发生。结论 治疗粘膜下子宫肌瘤 ,宫腔镜手术是最佳选择。正确选择手术适应证 ,提高手术质量 ,严格B超监测是提高术后疗效和手术安全性的保障。
Objective To treat every kinds of submucosal myoma by hysteroscopic surgery and to evaluate the effect and safety.Methods 78 cases of submucosal myoma which were diagnosed by hysteroscopy combined with ultrasound examination was performed transcervical resection of myoma (TCRM) and/or transcervical resection of endometrium (TCRE),due to abnormal uterine bleeding.And there were 22 cases of type 0,30 cases of typeⅠand 26 cases of type Ⅱ in all these cases.The period of follow-up was 3～33 months. On the basis of controlling bleeding,growth of myoma and subsequent surgery, the treatment results were divided into two groups:satisfaction and dissatisfaction.Results The growth of myoma and bleeding were controlled in 96 15% of all patients after resection. 0 and Ⅰ type got 100% satisfaction.In 10 patients who wanted to reserve fertility,4 got pregnancy, in which 3 got full term birth.There were 9 cases of the Ⅱ type myoma which were resected more than 70%.The residual myoma no longer grew.There was no complication in all these operations.Conclusion Hysteroscopic treatment is the first choice for submucosal myoma.Selecting proper indication for operation,improving the surgery quanlity and strict β ultrasound are the safeguard for ensuring effects and the safety of operation.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2002年第9期548-550,共3页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
子宫肌瘤
粘膜下肌瘤
宫腔镜术
疗效
安全性
手术指征
Uterine leiomyoma Submucosal myoma Hysteroscope Electrosurgery Curative effect
