宫腔镜电切术治疗宫内占位病变的临床分析

Clinical analysis of hysteroscopic treatment for intrauterine lesions

目的评价宫腔镜电切术治疗宫内占位病变的疗效及安全性。方法应用宫腔电切镜经阴道切除宫腔内占位病变126例,其中宫腔镜下子宫内膜息肉切除术(TCRP)70例,子宫黏膜下肌瘤切除术(TCRM)56例,并对其术中术后情况进行临床分析。结果手术成功率达100.0%,手术时间(45.9±11.2)min,术中出血量(40.8±8.7)ml。术前月经异常者102例,术后月经恢复正常或好转者96例(94.1%),贫血缓解率96.1%。18例痛经患者术后有12例缓解。5例不孕患者术后有3例正常妊娠分娩,其余仍在随访观察中。结论宫腔镜电切术治疗宫腔内占位病变,具有不开腹、不切开子宫肌层、创伤小、出血少、手术时间短、术后恢复快,以及更多地保留器官功能、更利于生殖预后等优点。

Objective To evaluate the clinical efficacy and safety of hysteroscopic treatment of intrauterine lesions. Methods A total of 126 patients with intrauterine lesions were treated by hysteroscopic surgery via vagina. Transcervical resection of polyp （TCRP） was applied to 70 patients and transcervical resection of myoma （ TCRM ） to 56 ones. Results The success rate of hyste- roscopic surgery was 100%. The average operative time was （45.9± 11.2） rain. The average blood loss was （40.8 ± 8.7 ） ml. Of the 102 patients with menstrual abnormalities before surgery, 96 （94.1% ） were improved or normal in menstruation after surgery. Among the 18 patients with dysmenorrheal, 12 were relieved after surgery. Among the 5 patients with infertility, 3 had normal preg- nancy and delivery thereafter. Conclusion With less bleeding,short operation time and rapid postoperative recovery, hysteroscopic surgery is a minimally invasive treatment method to intrauterine lesions. It does not affect the physiological structure and function of reproduction organs, conducive to reproductive prognosis.