宫腔镜电切治疗子宫内占位性病变43例疗效分析

Efficacy of Hysteroscopic Treatment for 43 Cases of Intrauterine Lesions

目的：探讨宫腔镜电切治疗子宫内占位性病变的临床效果。方法：回顾性分析43例子宫内占位性病变患者的临床资料,其中38例为子宫内膜息肉,5例为子宫黏膜下肌瘤,均在椎管内麻醉下行宫腔镜电切治疗术。观察手术时间、术中出血量和手术并发症,比较治疗前后Na^＋、K^＋、Cl^-、Ca^2＋浓度变化。结果：43例患者宫腔镜电切治疗过程顺利,手术均成功,无子宫穿孔、大出血、TCRP综合征、感染与腹痛等并发症,手术时间为13-42 min,平均（25.67±10.74）min,术中出血量为21-53 ml,平均（39.58±7.83）ml。与治疗前比较,治疗后Na^＋、Cl^-浓度明显降低（P〈0.05）,K^＋、Ca^2＋浓度有所降低,但与治疗前比较差异无统计学意义（P〉0.05）。结论：宫腔镜电切治疗子宫内占位性病变疗效好,具有手术时间短、术中出血量少、术后并发症少等优点,但应防治稀释性低钠血症、低氯血症。

Objective：To investigate the clinical efficacy of hysteroscopic treatment for intrauterine lesions.Method：A retrospective analysis of clinical datas of 43 patients with intrauterine lesions was done,38 cases were endometrial polyps,5 cases were endometrial fibroids.43 cases of intrauterine lesions were given hysteroscopic treatment with spinal anesthesia.The operation time,blood loss and surgical complications were observed,and the concentration of Na^＋,K^＋,Cl^-,Ca^2＋ were recorded before and after treatment.Result：43 cases of hysteroscopic resection were successful without complications（uterine perforation,bleeding,TCRP syndrome,infection,stomach pain）,operative time was 13-42 min,average was（25.67±10.74）min,intraoperative blood loss was 21-53 ml,average was（39.58±7.83）ml.After the treatment,compared with the before treatment,the concentration of Na^＋,Cl^- were significantly lower（P〈0.05）,there were not statistically significant difference in the concentration of K^＋,Ca^2＋（P〈0.05）.Conclusion：Hysteroscopic treatment for intrauterine lesions was effective with a shorter operative time,less blood loss,fewer complications,etc,but it should be prevention of hyponatremia and hypochloremia.