宫腔镜电切术治疗Ⅱ型子宫粘膜下肌瘤的安全性研究  

The Safety and Feasibility of Hysteroscopic Resection for Class II Submucosal Myoma

作　　者：张培海[1] 史晓丽 刘培淑[1] 董瑞英[1] 

机构地区：[1]山东大学齐鲁医院,山东济南250012 [2]烟台市芝罘区妇幼保健院,山东烟台264000

出　　处：《实用妇产科杂志》2008年第5期307-309,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的：探讨宫腔镜电切术治疗Ⅱ型子宫粘膜下肌瘤的可行性和安全性。方法：选择35例术前诊断为Ⅱ型子宫粘膜下肌瘤的患者,在超声监护下行宫腔镜电切术,根据患者的年龄及生育要求采用直接切除或开窗后切除,观察宫腔镜电切术治疗的可行性、安全性及疗效。结果：35例中32例一次手术切除肌瘤,一次手术成功率为91.42%,手术时间25-75分钟,术中出血量10-150ml。3例因肌瘤较大,1-3个月后行第二次手术切除。未发生经尿道前列腺电切综合征、子宫穿孔及邻近脏器的损伤。术后住院时间1-3天,术后2个月时月经量均正常。超声检查宫腔内膜光滑、均质。3例要求妊娠者,于手术1年后妊娠,均已足月分娩。结论：宫腔镜电切术治疗Ⅱ型子宫粘膜下肌瘤是安全、可行的,但术前一定要选择好肌瘤类型、大小,术中注意手术技巧和良好的监护。Objective ： To evaluate the feasibility and safety of hysteroscopic resection for class Ⅱ submucosalmyoma.Methods：35 patients were treated with hysteroscopy under ultrasound monitoring. Results： 32 myomas were resected successfully at one time of procedure. One-time resection rate was 91.42%. Duration of the procedure was 25 - 75 min （mean time 38 min）. Blood loss was 10 - 150 ml （mean volume 56 ml） .Three patients had second operation 1 to 3 months later due to larger myomasr. No TURP syndrome, uterine perforation or injury of the adjacent organs occurred. Hospital stay was 1 to 3 days. Menstrual blood loss became normal 2 months after the procedure and the endometrium became smooth then. 3 patients with intension of conception gave term birth. Conclusions： Hysteroscopic resection of class Ⅱ submucosal myomas was possible and safe. But the type, size and number of the myorna must be diagnosed accurately. Skills and monitoring during the procedure were also important to prevent complications.

关 键 词：宫腔镜 粘膜下肌瘤 安全性 

分 类 号：R737.33[医药卫生—肿瘤]