宫腔镜下Ⅱ型子宫黏膜下肌瘤电切术80例临床分析

Hysteroscopic myomectomy for type Ⅱ submucous myomas: an analysis of 80 cases

目的探讨宫腔镜下Ⅱ型子宫黏膜下肌瘤电切术的手术安全性和可行性。方法回顾性分析2013年1月至2017年12月于常州市妇幼保健院行宫腔镜下Ⅱ型子宫黏膜下肌瘤电切术患者80例,根据瘤体直径将患者分为A组42例(瘤体直径≤4cm)、B组38例(瘤体直径>4cm),比较两组的临床资料及手术情况。结果 A组患者年龄(41.00±0.92)岁,B组患者年龄(39.68±0.94)岁,两组差异无统计学意义。A组手术时间(24.40±0.86)min,术中出血量(8.33±0.79)mL,一次手术成功率100%;B组手术时间(48.55±1.78)min,术中出血量(32.24±3.51)mL,二次手术率52.6%,两组比较差异均有统计学意义(P<0.05)。A组住院时间(6.71±0.21)d,术后病率11.9%;B组住院时间(7.18±0.18)d,术后病率23.7%,两组比较差异无统计学意义(P>0.05)。结论宫腔镜下Ⅱ型子宫黏膜下肌瘤电切术是一种安全、可行、微创的手术治疗方式,对于瘤体较大者,仍可选择该术式。

Objective To analyze the security and feasibility of hysteroscopic myomectomy for type Ⅱ submucous myomas.Methods The clinical data of 80 cases of hysteroscopic myomectomy for type Ⅱ submucous myomas between January 2013 and December 2017 in Changzhou Maternal and Child Healthcare Center were analyzed retrospectively.According to the diameter of myoma,80 patients were divided into group A(less than or equal to 4 cm,42 cases)and group B(over 4 cm,38 cases).The clinical and surgical data were compared between the two groups.Results The mean age of group A was(41.00±0.92)years,and the mean age of group B was(39.68±0.94)years,there being no statistically significant difference between the two groups.The average duration of surgery of group A was(24.40±0.86)min.The average blood loss of operation of group A was(8.33±0.79)mL.The operation success rate of group A was 100%.The average duration of surgery of group B was(48.55±1.78)min.The average blood loss of operation of group A was(32.24±3.51)mL.The rate of secondary operation of group B was 52.6%.(P<0.05).The average time of hospital stay in group A was(6.71±0.21)days.The postoperative morbidity of group A was 11.9%.The average time of hospital stay in group B was(7.18±0.18)days.The postoperative morbidity of group B was 23.7%.There was no statistically significant difference between the two groups(P>0.05).Conclusion Hysteroscopic myomectomy to typeⅡ submucous myomas is a safe,feasible and minimally invasive technique for type Ⅱ submucous myomas.Hysteroscopic surgy is still an option for larger diameter typeⅡsubmucous myomas.