宫腔镜电切术治疗宫颈良性病变的疗效和价值

Hysteroscopic resection in the treatment of cervical benign lesion effect and value

目的研究宫腔镜电切术治疗宫颈良性病变的临床疗效与价值,总结治疗经验。方法选择于2011年5月—2012年5月在该院治疗的宫颈病变患者42例,以9mm灌流式宫腔电切镜以及球形电极、环形电极、电视成像系统、高频电流发生器,将电凝电机功率设为30～40w,切割电极功率设为50～60w,降温冲洗后以5%葡萄糖溶液进行持续灌流,以2%利多卡因行连续硬膜外麻醉,碘伏消毒宫颈、宫颈管、阴道,宫颈管息肉与宫颈糜烂者,将电切经环形电极置入宫颈管,自6点钟处由内向外切割糜烂面,切割范围大于糜烂面2～3mm,深度10～12mm,对息肉或带蒂肌瘤者沿根部切除效部组织,再以血管钳取下大部组织。结果 42例手术均十分成功,时间10～25min,平均17min,术中出血5～20mL,无一例发生子宫穿孔或组织损伤等并发症,有2例术后出血,以垂体后叶素湿纱布止血后好转,2例脱痂时阴道中量出血,给予电凝止血后好转,19例术后1～3周阴道分泌物增多,无需处理,42例患者均于术后2个月创面恢复正常,无任何并发症,24例术前血性分泌物、阴道分泌物增多,同房后出血患者经治疗后明显改善。结论宫腔镜电切术治疗宫颈良性疾病效果良好,且创伤小、恢复快,安全性高,值得推广。

Objective Clinical efficacy and value of hysteroscopic resection in the treatment of cervical benign lesion, summarize the experience of treatment. Methods In 2011 May to 2012 year in May for patients with cervical lesions in 42 patients treated in our hospital, with 9 mm perfused hysteroscopy and spherical electrode, electrode ring, TV imaging system, a high-frequency current generator, the electric coagulation motor power is 30~40w, the cutting electrode power is set to 50~60w, cooling after washing with 5% glucose solution was perfused with 2% lidocaine anesthesia, epidural, iodophor disinfection of cervical, cervical, vaginal, cervical polyps and cervical erosion, the electricity cut through the annular electrodes implanted in the cervical canal, since six o＇clock position from the inner to the outer cutting erosion, erosion surface cutting range is greater than 2~3mm, depth 10-12mm, polyp or pedunculated myomas resection effect along the root tissue, to remove tissue forceps. Results 42 cases of operation are very successful, time is 10-25 minutes, average 17 minutes, intraoperative bleeding was 5-20ml, no case of complications such as uterine perforation or tissue damage, bleeding in 2 cases, improvement in the posterior pituitary wet gauze to stop bleeding, 2 cases of vagina bleeding scab in, give electric coagulation hemostasis after the turn for the better, 19 cases after 1~3 weeks increased vaginal discharge, without treatment, 42 patients at 2 months after the operation wound recovered, no complications, 24 cases of preoperative bloody secretion, increased vaginal discharge, patients after treatment significantly improved bleeding after intercourse. Conclusion Hysteroscopic resection in the treatment of cervical benign diseases and good effect, small trauma, quick recovery, high security, is worthy of promotion.