摘要
探讨Nd∶YAG激光在宫腔镜下应用的可行性和临床疗效。方法选择6例功能失调性子宫出血和15例子宫粘膜下肌瘤共21例患者,应用Nd∶YAG激光在宫腔镜下行单纯去内膜术(6例)、单纯肌瘤摘除术(7例)和去内膜加肌瘤摘除术(8例)。结果21例手术全部获得成功,包括1例行2次手术者(第1次手术切除部分瘤体,第2次手术切除剩余瘤体并同时行去内膜术)。术后月经恢复正常13例,少经7例,1例月经仍多但较术前好转,病人满意率为100%。术前贫血的15例患者术后13例得到纠正,2例改善。无严重手术并发症。14例术前接受药物准备患者用药前后的宫腔深度分别为8.9cm±0.8cm和8.3cm±0.9cm,配对t检验差异有显著意义(P<0.05)。用药组和未用药组内膜萎缩程度的Mann-WhitneyU检验和Kolmogorov-Smirnov检验提示两组间差异无显著意义(P>0.05),但用药组内膜条件较未用药组略好。术中液体用量与手术时间的Pearson相关系数为0.55,P=0.028。结论在术前充分准备和术中尽量缩短手术时间的前提下,Nd∶YAG激光在宫腔镜下应用具有用途广、相对安全、疗效好的优点。手术前药物准备能显著缩小?
Objective To study the feasibility and curative effect of Nd∶YAG laser
application in hysteroscopic surgery. Methods A total of 21 cases were recruited, including 6
cases with dysfunctional uterine bleeding and 15 cases with submucosal uterine myoma.
Subsequently 6 endometrial laser ablation (ELA) only, 7 submucosal myomectomies and 8
myomectomies combined with ELA were performed. All cases were treated by Nd∶YAG laser
under hysteroscopic control. Results All 21 operations succeeded, including 1 case of
secondary operation in order to completely remove the myoma and to perform an ELA at the
same time after an incomplete myomectomy at the first time. Postoperatively the total patients'
satisfaction rate was 100%, including 13 cases with restored normal menstruation, 7 cases of
oligomenorrhea, 1 case still had menorrhea but with somewhat improvement compared with her
preoperative condition. In 15 cases with anemia, 13 cases were corrected and the other 2 cases
improved postoperatively. Noserious operative complication occurred. Of 14 cases who
received preoperative pharmacal preparation, uterine cavity depth were 8.9 cm ± 0.8 cm
before and 8.3 cm±0.9 cm after preparation. The paired t test indicated significant difference
(P<0.05). The Mann Whitney U test and Kolmogorov Smirnov test of endometrial atrophic
degree indicated no statistical difference between preparation and non-preparation groups (P>0.
05), but the endometrial condition in the preparation group was slightly better than that in the
non preparation group. The Pearson correlation coefficient between fluid deficit during
operation and operative time was 0 55 (P=0 028). Conclusions After careful preparation of
endometrium and as much as possible to reduce operative time, Nd∶YAG laser may have the
advantages of wide application, being relatively safe and showing good curative effect in
hysteroscopic surgery. Preoperative pharmacal preparation significantly reduced depth of the
uterine cavity, however, with little improvement of endometrial condition.
出处
《中国激光医学杂志》
CAS
CSCD
1999年第1期5-8,共4页
Chinese Journal of Laser Medicine & Surgery