子宫内膜切除术治疗月经过多患者的临床分析.pdfVIP

刘 超等 子宫内膜切除术治疗月经过多患者的临床分析 第4期 · 565· · 适宜技术 · 子宫内膜切除术治疗月经过多患者的临床分析① 刘 超 刘晶珠② 马 燕 崔淑萍③ 王爱梅④ 吉林大学第二医院(吉林 长春) 130041 中国图书分类号 R713 文献标识码 B 文章编号 1001-4411(2008)0441565．02 【摘 要】 目的：总结子宫内膜切除术治疗月经过多的手术指征、手术方法、预后及体会。方法：应用连续灌流官腔电 切镜，对400例手术指征为保守治疗无效的月经过多、无生育要求、合并粘膜下肌瘤直径≤5 cm的病人行子宫内膜切除术，其 中72例同时切除子宫肌瘤，术中子宫穿孔3例。术后随访3个月一4年者366例，其中13例因异常出血行第二次手术。结果： 16例因手术失败切除子宫，其余350例月经均有所改善，手术成功率95．6％。术后146例 (41．7％)无月经，119例 (34．0％) 月经为滴状，85例 (24．3％)经血明显减少，原有痛经者78．3％的痛经症状消失或减轻。术后远期合并症有异常出血22例， 宫腔积血5例，子宫腺肌病4例。结论：子宫内膜切除术可减少或停止月经，减轻痛经，同时切除肌瘤，疗效较满意。 【关键词】 子宫内膜 外科手术 月经过多 平滑肌瘤 Analysis of outcomes of transcervical resection of endometrium in 400 cases with menorrnagia． · LlU Chao，LlU jing—Zhu，MA Yan，et a1．Second Hospital ofJilin University，Changchun 130041，Jilin，China． [Abstract) Objective：To report the efficacy and outcomes of transervical resection of endometrium(ECRE)in treatment of men— orrhagia~Methods：Among them，72 patients with submucous uterine myoma less than 5 cm in diameter had their myoma resected simulta— neously，366 cases were followed up postoperatively for 3 months to 4 years．13 of them had a second operation．Results：TCER was per— formed successfully except 16 cases，giving a success rate of 95．6％．Three cases sustained uterine perforation．During follow—up，146 ca— ses(41．7％)became amenorrhea，119(34．0％)had only spotting．The remaining 85(24．3％)had normal periods，78．3％who previ— ously had dysmenorrhea had relieved their pain．Long—term complications were recurrent abnormal uterine bleeding of 22 cases，hematometra 5 cases and adenomyosis 4 cases．Conclusion：TCRE is an effective procedure in treating menorrhagia and small submucous uterine myoma． [Key words] Endometria；Surgery；Hypermenorrhea；Leiomyoma 经宫颈子宫内膜电切术 (transcervical resection of the endo— 疾患；③已无生育要求；④子宫≤妊娠10周大小；⑤官腔深 metr