双极汽化电切技术在绝经后妇女宫腔内病变的应用

The application of bipolar electronic scalpel system in treating uterus cavity diseases of postmenopausal women

目的 探讨双极汽化电切技术在绝经后妇女的良性宫腔病变的应用。方法 患者为 2 0 0 1年 1 0月～ 2 0 0 3年 4月于我院妇科病房收治的接受宫腔镜手术治疗的绝经后妇女。术后病理诊断为子宫内膜息肉或粘膜下子宫肌瘤的患者共 1 0 4例。患者分为A、B两组。A组 5 4例 ,给予双极系统电切除手术 (TCRP或TCRM) ;B组 5 0例 ,给予单极系统切除手术。手术在连续硬膜外麻醉下进行 ,应用Versapoint系统 (Gynecare)和单极电切(Olympus)系统。所得组织均送病理检查 ,证实诊断。结果 患者平均年龄 6 3 0± 6 2岁 (4 8～ 74岁 ) ,平均绝经时间 1 2 4± 7 4年 ,阴道分娩次数 2 0± 1 2次 (0～ 4次 ) ,1 5 38% (1 6 / 1 0 4例 )无阴道分娩史 ,4 0 38% (4 2 / 1 0 4例 )单独合并高血压等心血管疾病 ,5 77% (6 / 1 0 4例 )单独合并糖尿病 ,另 5 77% (6 / 1 0 4例 )同时合并高血压和糖尿病。A、B两组患者在平均年龄、绝经时间和阴道分娩次数相匹配。比较两组的手术结果 :术后均未见复发 ;B组 1例患者手术中发现子宫穿孔。A组平均手术时间较B组缩短 (P <0 0 5 ) ,差异有显著性。结论 在绝经后妇女的宫腔镜手术中 ,双极系统可以节省手术时间而且是比较安全 ,有效的。

Objective To investigate the application of bipolar electronic scalpel system in benign diseases in uterus cavity of postmenopausal women. Methods One hundred and four postmenopausal women, with endometrial polyps or submucosa leiomyoma of uterus diagnosed pathologically, were treated by TCRP or TCRM with different systems: bipolar electronic scalpel system (GA) and monopolar system (GB) in our hospital from Oct.2001 to Apr.2003. Results There was no difference between GA and GB with respect to average age, postmenopausal duration and times of vaginal deliveries. No recurrence of the disease happened in either group. Uterine perforation occurred in one case of GB during the operation. However, the average time of operation in GA was statistically shorter than that in GB, P <0.05. Conclusions Bipolar electronic scalpel system is safe, effective and can also shorten the operation time while treating uterus cavity diseases in postmenopausal women.