宫腔镜下Nd∶YAG激光手术治疗子宫粘膜下肌瘤

Treatment of Submucosal leiomyoma of Uterus Under Hysteroscopy by Nd∶YAG Laser

目的 探讨宫腔镜下Nd∶YAG激光手术治疗子宫粘膜下肌瘤的安全性和有效性。方法 收集 1996年 1月至 2 0 0 0年 8月在我院施宫腔镜下Nd∶YAG激光手术治疗子宫粘膜下肌瘤的 14 7例患者的临床资料 ,进行总结分析。结果 所有手术均顺利进行 ,宫腔深度 6 5～ 12 0cm ,平均 8 5cm ,手术时间 5～ 80min ,平均 2 5min。病理检查证实 14 0例为子宫粘膜下肌瘤 ,7例为子宫内膜息肉。 14 0例子宫粘膜下肌瘤激光汽化手术中 ,12 9例 1次手术成功 ,11例 2次手术成功 ,术中术后未发生严重并发症 ,临床治愈率为 96 8%。术后随访 3～ 2 4个月 ,113例经妇科、B超检查宫腔内无占位性病变 ;3例不育症患者中 ,2例已妊娠并生育。结论 宫腔镜下Nd∶YAG激光手术治疗子宫粘膜下肌瘤是一种安全、可行和有效的方法。

Objective To investigate the effectiveness and safety of treatment of submucous leiomyoma of uterus under hysteroscopy by Nd∶YAG laser. Methods There were 147 cases of submucous leiomyoma treated by Nd∶YAG laser cutting and vaporization from Jan, 1996 to August, 2000. Results All surgeries were performed successfully. The mean uterine depth was 8 5 cm (6 5-12 cm), mean operative time was 25 minutes (5-80 minutes). There were 129 leiomyomaecxtomies succeeded without repeated surgery. Eleven cases leiomyoma were excised with two surgeries. There were no serious complications occurred during or after operations. The clinical curative rate was 96 7%. Intrauterine neoplasm disappeared in all cases during a follow up 113 cases for 1-24 months. Two out of 3 infertile patients had got pregnancy and delivered. Conclusions It is shown that treatment of submucosal leiomyoma under hysteroscopy by Nd∶YAG laser is safe, feasible and highly effective.