宫腔镜电切术后放置T型节育器预防粘连455例临床观察

Study on setting T type anticonceptive device after hysteroscope electrocision to prevent accretion in 455 cases

目的宫腔镜电切术后放置T型节育器预防宫腔或宫颈管粘连.方法行宫腔镜电切术455例,于电切手术结束应用催产素10～20 u静注后观察无出血,探测宫腔深度后放置T型节育器.根据电切类型不同,于术后1～3个月取出节育器,然后行B超检测,观察宫腔内有无积液,判断是否存在宫腔或宫颈管粘连.结果术后2个月随访并行B超检测,其中电切子宫黏膜下肌瘤245例,宫腔积液1例(1/245例,0.41%);电切子宫内膜78例,电切子宫内膜息肉72例,电切宫颈管肌瘤或息肉37例,子宫纵隔切除9例,宫腔粘连分离术5例,宫腔异物取出9例,B超检测均未发现宫腔积液.结论宫腔电切术放置T型节育器对预防宫腔或宫颈管粘连有效,有效率达99.78%,值得推广.

[Objective] To prove setting T type anticonceptive device after hysteroscope electrocision can prevent accretion of cavitary uteri or cervical canals. [Method] T type anticonceptive device were set in 455cases after hysteroscope electrocision and detecting the depth of cavitary uteri if no bleeding. T type anticonceptive device were dislodged after one to three months according to the modes of electrocision. Patients were examed by ultrasonic testing and be diagnosed accretion of cavitary uteri （cervical canals） or not on the basis of fluidify in cavitary uteri. [Results] One case had fluidify in cavitary uteri in 245 patients of submucous myoma after hysteroscope electrocision （1/245,0.41%）. No fluidify in cavitary uteri were found in 78 cases of endometria electrocision, 72 cases of endometrial polyps eleetrocision, 37 cases of muscular tumors or polyps electrocision in cervical canals, 9 cases of uterus septum electrocision, 5 cases of cavitary uteri synechiolysis and 9 cases foreign object dislodging. [Conclusion] Setting T type anticonceptive device after hysteroscope electrocision is useful to prevent accretion of cavitary uteri or cervical canals, and the effective power was 99.78%.