摘要
目的探讨宫腔镜电切术治疗子宫黏膜下肌瘤的临床效果及影响预后的相关因素。方法1999年1月至2004年11月,威海市妇女儿童医院对146例经宫腔镜联合超声检查发现子宫黏膜下肌瘤行宫腔镜肌瘤电切手术。其中0型40例,Ⅰ型55例,Ⅱ型51例。术前排除恶性病变。术中超声全程监护。术后连续随访。结果146例患者手术均顺利完成,所有0型、Ⅰ型黏膜下肌瘤均一次切净,Ⅱ型中有11例未能全部切除,切除范围≥70%。手术满意率达96·6%,无一例发生子宫穿孔。行米非司酮药物预处理2个月后子宫平均缩小25·3%,最大肌瘤平均缩小34·6%。14例有生育要求者,10例妊娠(71·4%),其中8例已足月分娩。结论宫腔镜电切术是治疗子宫黏膜下肌瘤的最佳方法。严格选择手术适应证,严格遵守操作规范是提高手术成功率,提高安全性及手术预后的关键因素。
Objective To study the correlation factors of prognosis and clinical effects of treating submucous myoma by hysteroscope electrotomy. Methods Hysteroscope electrotomy was used to treat 146 cases of submucous myoma diagnosed by hysteroscope and B-mode uhrasonography from January 1999 to November 2004 in Weihai Municipal Maternal and Child Hospital. Type 0 40 cases,type Ⅰ 55 cases and type Ⅱ 51 cases, all of them were excluded the malignant pathological change. B-mode ultrasonography monitored the whole operation and all cases were followed up afteroperation. Results The 146 patients were operated successfully, all type 0 and type Ⅰ submucous myoma were excised in total, 11 cases of type Ⅱ were not excised in toal but their excise range≥70%. The operation satisfaction rate was up to 96. 6%. There was not one case of uterine perforation. Uterine deflated 25.3% on average and the max muscular tumor deflated 34. 6% after pretreated by Mifepristone for 2 months. 10（71.43% ）cases had pregnancy among 14 cases who wanted to bear, and 8 cases of them already matured to give birth. Conclusion Hysteroscope electrotomy is a preferred way to treat submucous myoma. Stipulating strictly the operation indications and the operation norm is the key to security and improving prognosis.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2005年第9期545-547,共3页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
子宫黏膜下肌瘤
宫腔镜电切术
超声
Submucous myoma Hysteroscope electrotomy Uhrasonography
