电视宫腔镜电切术术前准备方式探讨  

STUDY OF PREPARATION METHODS BEFORE VIDEO HYSTEROSCOPIC ELECTRIC RESECTION

作　　者：刘穗玲[1] 谌小卫[1] 李小毛[1] 陈京力[2] 罗启东[2] 陈湘云[2] 

机构地区：[1]中山大学附属第三医院妇产科,510630 [2]中山大学孙逸仙纪念医院妇产科,510120

出　　处：《中国内镜杂志》2003年第3期43-45,48,共4页China Journal of Endoscopy

摘　　要：目的 :探讨电视宫腔镜电切术术前准备的合理方式。方法 :1 0 8例宫腔镜电切手术 ,术前全部患者行B超、宫腔镜检查并刮宫或活检标本作病理检查 ;子宫内膜切除术患者于月经周期早期手术 ,其余患者手术时机不限 ;术前宫腔插管或舌下含服 40 0 μg米索前列醇扩张宫颈。对手术时机、手术经过以及随访结果进行分析。结果 :子宫内膜切除术手术时间在月经第 4～ 7天 ,中位数第 5天 ;其余患者手术时间在月经周期第 5～ 2 8d ,中位数第 1 0天 ;1 1例绝经后出血患者于出血控制后手术。术前宫腔插管或舌下含服 40 0 μg米索前列醇均均能顺利通过 9号Hegar扩张器。 98例子宫内膜切除术、子宫粘膜下肌瘤切除、子宫内膜息肉切除术手术时间2 9.2± 1 7.9min(5～ 95) ,有效率 95 .8% ;1 0例腹腔镜下子宫纵隔切开术手术时间 61 .0± 9.7min(50～80min) ,术后 2例妊娠。结论 :B超、宫腔镜检查是宫腔镜手术前必要的评估手段 ;电视宫腔镜电切术不作术前预处理是可行的。米索前列醇术前扩张宫颈效果好。Objective:To study the preparation methods before hysteroscopic electric resection.Methods:Before the hysteroscopic electric resection,all of the 108 patients accepted B ultrasound scan,hysteroscopy and endometrial pathologic examination.Transcervical endometrium resection was done in the early stage of the menstrual period.Preoperative catheter insertion or oral misoprostol were used to dilate the cervix.The operative data and the therapeutic effect are analyzed.Results:Endometrium resection was done on the 4th～7th day of the menstrual period.The other operations were done on 5th～28th days of the periods(medium the 10th day).Postmenopausul hemorrhaged is controlled before operation.No.9 Hegar dilator can pass the cervis easily in the patients accepting catheter insertion or oral misoprostol.Ninty-eight cases transcervical endometrium resection,transcervical myoma resection,transcervical polyp resection were done.The operating time ranged from 5 to 95 minutes(mean 29.19±17.90 minutes).The effective rate was 95.79%.Ten cases transcervical septum resection after laparoscopy were done.The operating time ranged from 50 to 80 minutes(mean 61.00±9.66 minutes).Two patients became pregnant after the operation.Conclusions:B ultrasound scan,hysteroscopy and endometrial pathologic examination were necessary exams before hysteroscopic operation.Transcervical endometriam resection can be done on the 4th～7th day of the menstrual period without endometium preparation.Misoprostol can be used to dilate the cervix effectively

关 键 词：宫腔镜检查 电外科手术 术前准备 子宫手术 子宫肿瘤 

分 类 号：R713.4[医药卫生—妇产科学] R737.33[医药卫生—临床医学]