尿毒症妇女月经过多的宫腔镜治疗

TREATMEN FOR MENORRHAGIA WITH UREMIA BY TRANSERVICLAL RESECTION OF ENDOMETRIUM HYSTEROSCOPICALLY

目的 :探讨宫腔镜治疗尿毒症妇女月经过多的可行性和有效性。方法 :应用宫腔镜对 16例尿毒症妇女施行宫颈子宫内膜电切术。结果 :所有病例均成功地在宫颈局部麻醉下实施子宫内膜电切术 ,宫腔深度 7.5～12 .5cm ,平均 9.2cm ;术中出血量 30～ 12 0ml,平均 (5 5± 2 6 )ml;手术时间 18～ 5 2min ,平均 (4 1.38± 14.2 6 )min ;术后住院时间 2～ 5d ,平均 (2 .6± 1.3)d。无 1例发生并发症。切除的子宫内膜组织量 5 .1～ 16 .5 g ,平均10 .3g ,其中子宫内膜增生过长 4例 (单纯型增生过长 3例 ,腺囊型增生过长 1例 ) ,子宫内膜息肉 4例。术后随访 6个月 ,闭经率达 81.3% ,治疗的有效率为 10 0 %。结论 :宫腔镜下子宫内膜电切术治疗尿毒症妇女异常子宫出血具有安全、有效的特点 ,耐受性良好 。

Objective:To evaluate the feasibitlity and effectiveness of transcervical resection of endometrium (TCRE) hysteroscopically for the treatment of menorrhagia with uremia. Method:Sixteen cases of menorrhagia with uremia were cured by TCRE.Results:All cases had been treated by TCRE successfully under local anaesthesia.The average depth of uterine cavity was 9.2cm (7.5～12.5cm).The mean blood loss were only 55±26ml(30～120ml).It was consumed 18～52min(mean 41.38±14.26min)for the operation.The hospitalization periods were 2～5 days(2.6±1.3d) after TCRE.No comlication occurred in the study.the weight of endometrium ablated were ranged from 5.1～16.5g(10.3g in average).There were 4 cases with endometrium hyperplasia (simple hyperplaisa in 3 cases,cystadeno hyperplasia in 1 case)and another 4 cases with endometrial polyps.The amenorrhea rate reached 81.3 percent during six months follow-up.The general cure rate was 100 percent.Conclusions:It was safe and effective for the treatmnet of menorrhagia with uremia by TCRE.Patients could tolerated TCRE under local anaesthesia.