宫腔镜电切术治疗宫颈管炎性病变的临床研究

Clinical study on treatment of inflammatory endocervical lesion by hysteroscopic electrosection

目的 探讨宫腔镜电切术治疗宫颈管炎性病变的可行性及临床疗效。方法 应用宫腔镜电切技术对我院 2 0 0 1年 1月～ 2 0 0 3年 1月 10 5例宫颈管炎性病变患者行宫颈管炎性病变组织切除术 ,术后随访 10 1例 ,平均随访 15个月 (1～ 2 4个月 )。结果 平均手术时间为 8.5min ,术中平均出血量为 8.6ml,术后感染率为2 .97% ,6例脱痂出血量超过月经量 ,一次性治愈率为 97.0 3% ,一次性有效率为 10 0 %。 3例病变残留者 ,经二次电切术治愈。 3例术后病理为宫颈上皮内瘤样病变 (CIN)者 ,另行宫颈锥形切除术得以证实。术后均无宫颈狭窄、闭锁及炎症复发。结论 宫腔镜电切术治疗宫颈管炎性病变 ,具有直视下操作定位准确、手术时间短、出血少、术后并发症少、恢复快、治愈率高等优点 ,同时其有诊断与治疗的双重作用 ,为宫颈管炎性病变的最佳治疗方式 ,值得推广应用。

Objective To determine the feasibility and clinical efficacy of treating inflammatory endocervical lesion by hysteroscopic electrosection. Methods Inflammatory endocervical lesions were resected by hysteroscopic technique and in turn for pathologic examination. 101/105 cases were followed-up, the mean follow-up duration was 15months(1～24 months). Results Averagely,the procedure took only 8.5 minutes, the average blood loss was 8.6 ml and the rate of postoperative infection was 2.97%. In 6 cases,the blood loss exceeded that of menstrual blood during decrustation. The cure rate was 97.03%, with an effective rate of 100%. In 3 cases the residual lesions were cured through a second electrosection. The postoperative pathologic diagnosis was CIN in 3 casers which was confirmed by conical cervical resection. No cervical strictture or atresia or recurrence of inflammation occurred during follow-up. Conclusion Hysteroscopic electrosection is the best treatment of inflammatory endocervical lesion,having the advantages of correct localization, short operation duration,less blood loss, few postoperative complications, rapid recovery and high cure rate. It has dual effect on diagnosis and treatment worthy for recommandation.