宫腔镜电切术治疗黏膜下Ⅱ型子宫肌瘤的安全性评价(1)
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2011年1月15日
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[摘要] 目的：评估宫腔镜子宫肌瘤切除术(TCRM)治疗Ⅱ型黏膜下子宫肌瘤的手术安全性。方法：回顾性分析本院近5年来51例采用TCRM手术治疗的Ⅱ型黏膜下子宫肌瘤患者的资料，并进行术后的系统随访。结果：51例患者一次手术成功率为92.2%。手术时间为31～97 min，平均(45.1±11.1) min。共切除肌瘤59个，肌瘤直径为2.5～5.8 cm，平均直径(3.7±1.1)cm；切除肌瘤组织重量为10～78 g，平均(35.1±12.5)g。术中出血量15～500 ml，平均(35.6±10.5)ml。手术前后，除血糖应激性增高外(P<0.05)，其他主要血生化指标均无明显变化(P>0.05)。术后有一过性发热8例，低钠血症4例，子宫穿孔1例。和同期采用TCRM治疗的0型和I型黏膜下子宫肌瘤患者相比，并发一过性发热和低钠血症的概率相似(P>0.05)；而子宫穿孔Ⅱ型黏膜下子宫肌瘤发生率为1.96%，高于Ⅰ型肌瘤的0.88%，和0型肌瘤的0.00%，但差异仍未有统计学意义(P>0.05)。结论：宫腔镜子宫肌瘤切除术治疗Ⅱ型黏膜下子宫肌瘤安全，值得推广。术中的严密B超监护和谨慎的手术操作是减少并发症的关键。
[关键词] 子宫肌瘤；黏膜下子宫肌瘤；宫腔镜子宫肌瘤切除术；安全性
[中图分类号] R737.33[文献标识码]A [文章编号]1674-4721(2011)01(b)-012-03
The safety evaluation of hysteroscopic resection for type Ⅱ submucosal uterine fibroids
ZENG Hua
(People's Hospital of Louxing District of Loudi City, Hunan Province, Loudi 417000, China)
[Abstract] Objective: To evaluate the surgical safety of hysteroscopic myomectomy (TCRM) treatment for type Ⅱ submu co-sal uterine fibroids. Methods: A retrospective analysis of 51 patients with type Ⅱ submucosal uterine fibroids for TCRM surgical treatment in the last 5 years in our hospital was conducted. We accessed the safety by systematic postoperative followed-up. Results: The success surgical rate of 51 patients was 92.2%. The operation time span was 31-97 minutes, average (45.1±11.1) minutes. A total of 59 fibroids were removaled, myoma diameter span was 2.5-5.8 cm, average (3.7±1.1) cm; tissue weight span of removal fibroid was 10-78 g, average (35.1±12.5) g. Blood loss span was 15-500 ml, average (35.6±10.5) ml. Blood glucose were increased for surgical stress before and after surgery (P<0.05), other parameters of blood biochemical had no significant changes (P>0.05). Postoperative complications included 8 patients with a transient fever; 4 patients with hyponatremia; 8 patients with uterine perforation. Compared with patients with 0-and I-submucosal uterine fibroids, it had similar opportunities for transient fever and hyponatremia (P>0.05); but submucous myoma rate of type Ⅱ uterine perforation was 1 ......
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