子宫内膜切除术治疗月经过多患者的临床分析

Analysls of outcomes of transcervical resection of endometrium in 400 cases with menorrhagia.

目的：总结子宫内膜切除术治疗月经过多的手术指征、手术方法、预后及体会。方法：应用连续灌流官腔电切镜，对400例手术指征为保守治疗无效的月经过多、无生育要求、合并粘膜下肌瘤直径≤5cm的病人行子宫内膜切除术，其中72例同时切除子宫肌瘤，术中子宫穿孔3例。术后随访3个月-4年者366例，其中13例因异常出血行第二次手术。结果：16例因手术失败切除子宫，其余350例月经均有所改善，手术成功率95．6％。术后146例（41．7％）无月经，119例（34．0％）月经为滴状．85例（24．3％）经血明显减少，原有痛经者78．3％的痛经症状消失或减轻。术后远期合并症有异常出血22例，宫腔积血5例，子宫腺肌病4例。结论：子宫内膜切除术可减少或停止月经，减轻痛经，同时切除肌瘤，疗效较满意。

Objective： To report the efficacy and outcomes of transervical resection of endometrium （ECRE） in treatment of menorrhagia. Methods： Among them, 72 patients with submucous uterine myoma less than 5 cm in diameter had their myoma resected simultaneously, 366 cases were followed up postoperatively for 3 months to 4 years. 13 of them had a second operation. Results： TCER was performed successfully except 16 cases, giving a success rate of 95.6%. Three cases sustained uterine perforation. During follow - up, 146 cases （41.7%） became amenorrhea, 119 （34. 0% ） had only spotting. The remaining 85 （24. 3% ） had normal periods, 78. 3% who previ- ously had dysmenorrhea had relieved their pain. Long - term complications were recurrent abnormal uterine bleeding of 22 cases, hematometra 5 cases and adenomyosis 4 cases. Conclusion： TCRE is an effective procedure in treating menorrhagia and small submucous uterine myoma.