肌壁间肌瘤的宫腔镜下激光治疗术

Hysteroscopic Nd:YAG Laser Treatment of Intermural Liomyomas of the Uterus

目的 :探讨宫腔镜下激光手术治疗子宫肌壁间肌瘤的安全性和有效性。方法 :对 1996年 2月至 2 0 0 0年11月间 ,经宫腔镜下 Nd:YAG激光治疗子宫肌壁间肌瘤的 10 3例患者资料进行总结分析。结果 :10 3例患者中 68例为月经过多 ,其中 4例合并不育 ,32例月经量偏多妇科检查发现 ,3例为绝经后阴道流血。其中 2 7例肌瘤完全切除 ,子宫恢复正常大小 ,76例为突出于宫腔内部分肌瘤切除。其中 81例施一次手术 ,术后 2 0例月经恢复正常 ,3例绝经后流血治愈 ,58例月经量显著减少 ;2 0例施两次手术 ,术后 7例月经恢复正常 ,13例月经量显著减少 ;2例施三次手术后月经量显著减少。月经恢复正常率为 2 7.0 0 % ,有效率为 10 0 %。 4例不育病人术后 3例妊娠。无术中、术后并发症。结论 :宫腔镜下 Nd:YAG激光治疗子宫肌壁间肌瘤是一种提高生命质量的安全。

Objective: To evaluate the effectiveness and safety of hysteroscopic Nd:YAG laser treatment of intermural liomyomas. Materials and methods:103 cases of intermural liomyomas were treated from Feb.1996 to Nov. 2000 using Nd:YAG laser treatment. Results:103 cases:68 metrorrhagia severity (including 4 cases infertility),32 cases metrorrhagia, 3 cases postmenopausal bleeding after operation,27 cases the liomyomas were excised completely and uterus recovered to normal,76 cases of them were excised partially.81 cases of them were experience operation only,20 cases were experienced twice, 2 cases experienced three times. The normal menstruation recovery rate was 27% and effective rate 100%. 3 cases were pregnancy (pregnancy rate 75%).No intraoperative or postoperative complication was found. Conclusion: We would conclude that treatment of intermural liomyomas with hysteroscopic Nd:YAG Laser may be a safe, feasible and highly effective new procedure.