B超引导下宫腔镜电切术治疗子宫肌瘤136例临床分析

Clinical analysis of the treatment of uterine fibroid by B ultrasound-guided hysteroscopic surgery

目的探讨B超引导下经阴道宫腔镜电切术(TCRM)在子宫肌瘤中的临床应用。方法子宫肌瘤136例,其中0型65例,Ⅰ型50例,Ⅱ型21例;肌瘤大小1～2cm者7例,2～4cm者49例,4～6cm者78例,6～8cm者2例;合并月经过多者117例,痛经者40例,贫血者52例。采用B超引导下经阴道宫腔镜电切术治疗,术后随访3个月～2年,观察患者各项症状的改善情况。结果 136例肌瘤患者均手术成功,无一例发生子宫穿孔、大出血、感染等并发症。全部病例随访3个月～2年,满意率达96.3%(131/136)。117例月经过多患者中112例基本改善,5例稍有缓解;40例痛经者38例症状消失,2例明显缓解;52例贫血者均得到纠正。结论宫腔镜电切术治疗子宫肌瘤操作简单、安全、治疗效果好,患者痛苦小、创伤小、术中出血少、恢复快,值得临床推广应用。

Objective To discuss on the clinical application of uterine fibroid under B ultrasound-guided transvaginal hysteroscopic surgery （TCRM）.Methods 136 cases of uterine fibroid,including 65 cases of type 0,Ⅰ type 50 cases,Ⅱ in 21 cases;The size of 1-2 cm in 7 patients with fibroid,2-4 cm in 49 cases,4-6 cm for 78 patients,6-8 cm in 2 cases;117 cases were combined with menorrhagia,dysmenorrhea in 40 cases,52 cases of anemia.By B ultrasound-guided transvaginal hysteroscopic resection for treatment.Observing their improved situation of the patients after 3 months-2 years.Results Patients were 136 cases of myoma operation is successful,no case of uterine perforation,bleeding,infection and other complications.All patients were followed for 3 months to 2 years,satisfaction rate of 96.3% （131/136）.117 cases of 112 cases of patients with menorrhagia capital improvement,a slight easing in 5 cases.40 cases of dysmenorrhea symptoms,disappeared in 38 cases,2 cases were relieved;Caught 52 cases of anemia was corrected.Conclusion Hysteroscopic treatment of uterine fibroid is simple,safe,effective treatment,the patient less pain,less trauma,less bleeding,quicker recovery,is worthy of clinical application.