门诊宫腔镜电切术治疗宫腔内良性病变357例

Transcervical resection via hysteroscopy for benign diseases in uteri of outpatients

目的探讨门诊宫腔镜治疗子宫腔内良性占位性病变的临床疗效及手术的安全性。方法分析2008年9月—2010年10月应用宫腔镜检查同时行电切术治疗宫腔内良性占位性病变357例的临床资料。其中子宫肌瘤切除(TCRM)71例,宫腔息肉切除(TCRP)272例,妊娠组织残留清除14例,术后随访2个月～3年。结果患者手术均一次成功,手术时间7～40 min,平均12 min,术中无并发症发生,术后95.78%的患者月经正常,1例宫腔息肉术后应用激素后复发,再次电切治愈。结论门诊宫腔镜检查及电切治疗宫腔内良性占位性病变,具有不可替代的优越性,能保留子宫的完整性,安全、经济、损伤小、恢复快、痛苦轻,可作为宫腔病变的首选治疗方法。

Objective To study the efficacy and safety of hysteroscopic treatment of benign disease in uterus in outpatients. Methods A total of 357 patients with benign disease in uterus, who were inspected via hysteroscopy and cured by electrocision, i.e. trans- cervical resection （TCR） from September 2008 to October 2010, were retrospectively analyzed. Out of the patients, 71 underwent hysteromyomectomia, 272 underwent polyp-endometrectomy, and 14 underwent residual pregnancy tissue removal. The patients were followed up from two months to three years after operation. Results All the patients were treated successfully by TCR within 7 -40 minutes （average = 12 minutes）. No complication occurred in operation. Postoperative menses became normal in 95.78% of the patients. One patient, who had experienced polyp-endometrectomy, suffered from polyp recurrence due to application of sex hormone and got cured by a second operation.：~ Conclusion TCR via hysteroscopy has an irreplaceable superiority because of its advantages of uterine reservation, safety, economy, minimal invasion, quick recovery, less pain and so on. So it is the first choice for benign disease in uterus.