宫腔电切镜锥形电切宫颈出血原因分析及处理  

Analyses of causes and managements of bleeding in cervical conization by hysteroscopic electrosection

作　　者：蒋兴伟[1] 钟玲[1] 胡丽娜[2] 曾飚[1] 王勇[1] 况明英[1] 

机构地区：[1]重庆医科大学附属第二医院妇产科,400010 [2]四川大学华西第二医院,成都610041

出　　处：《重庆医学》2007年第3期245-246,248,共3页Chongqing medicine

摘　　要：目的探讨宫颈锥形电切术中及术后脱痂期出血的原因及处理方法。方法2000年1月-2005年8月重庆医科大学附属第二医院应用宫腔电切镜锥形电切治疗慢性宫颈炎(肥大组和无肥大组)及宫颈肌瘤(肌瘤组)共1 158例。对3个组出血发生率进行比较,并分析发生出血的原因及处理方法。结果术中出血发生率5.79%,3组比较,差异无统计学意义(P>0.05)。脱痂期出血发生率7.08%,肥大组脱痂期出血发生率明显高于无肥大组,差异有统计学意义(P<0.01),但该两组与肌瘤组比较差异无统计学意义(P>0.05)。术前或(和)术后宫颈局部有感染者脱痂期出血发生率明显高于无感染者,差异有统计学意义(P<0.01)。结论宫颈锥形电切术中出血发生率与病变类型无关;宫颈肥大者切割深度不易掌握,致脱痂期出血发生率高,术前或(和)术后宫颈局部感染者易发生脱痂期出血。宫颈局部压迫、热凝、止血药物及抗生素的应用是治疗出血的有效方法。Objectives To analyse the causes and managements of bleeding in cervical conization by hysteroscopic electrosection. Methods 1 158 cases including chronic cervicitis （hypertrophic group and no hypertrophic group） and cervical myomas （ myomas group ） were given cervical conization by hysteroscoplc electrosectlon from Jan. 2000 to Aug. 2005 in our hospital. The rates of bleeding were compared in these three groups. The causes and treatments of bleeding were analysed. Results The rate of bleeding was 5.79 % during operation. There were no statistic differences in these three groups （P〉0. 05）. The rate of bleeding was 5. 79% during decrustation. The rate of bleeding in hypertrophic group during decrustation was higher than this in no hypertrophic group （P〈0.01）. There were no statistic differences while comparing these two groups with myomas group （P〉0. 05）. The rate of bleeding was higher in cervical infection group than this in no infection group during decrustation （P〈0.01）. Conclusion There is no relation between the rate of bleeding and pathological types in cervical conization by hysteroscopic electrosection. The rate of bleeding is higher during decrustaion because the depth of cutting is hard to control in hypertrophic group. Cervical infection during or （and） after operation is easier to bleed during decrustaion. Local pressing cervix, hot coagulation, usage of hemostatic and antibiotics all are effective methods in treatment of bleeding.

关 键 词：子宫颈疾病 宫颈锥形切除术 电外科学 并发症 

分 类 号：R713[医药卫生—妇产科学]