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目的探讨宫腔镜肌瘤电切术(TCRM)治疗子宫黏膜下肌瘤的安全性。方法选取30例术前诊断为子宫黏膜下肌瘤的患者,在超声监护下行宫腔镜电切术,根据患者的年龄及生育要求采用直接切除或开窗后切除,观察宫腔镜电切术治疗的可行性、安全性及疗效。结果 30例中29例一次手术切除肌瘤,一次手术成功率为96.7%,手术时间10~60 min,术中出血量5~100 ml。1例因肌瘤较大,3个月后行第2次手术切除。未发生经尿道前列腺电切综合征、子宫穿孔及邻近脏器的损伤。术后住院时间1~3 d,术后2个月时月经量均正常。超声检查宫腔内膜光滑、均质。3例要求妊娠者,于手术1年后妊娠,均已足月分娩。结论宫腔镜电切术治疗子宫黏膜下肌瘤是安全、可行的,但术前一定要选择好肌瘤类型、大小,术中注意手术技巧和良好的监护。
Objective To investigate the safety of hysteroscopic myomectomy (TCRM) in the treatment of uterine submucosal fibroids. Methods Thirty patients with preoperative diagnosis of uterine submucous myoma were enrolled in this study. Hysteroscopic resection under ultrasound was performed. According to the patient’s age and fertility requirements, direct resection or resection of the fenestration was performed. Hysteroscopic resection Feasibility, safety and efficacy of treatment. Results Twenty-nine of 29 patients underwent a surgical resection of fibroids. The success rate of one operation was 96.7%. The operation time was 10 to 60 minutes and the intraoperative blood loss was 5 to 100 ml. A case of larger fibroids, 3 months after the line of the second surgical resection. Transurethral resection of the prostate does not occur, uterine perforation and adjacent organs damage. The postoperative hospital stay was 1 to 3 days, and the amount of menstruation was normal after 2 months. Uterine endometrial ultrasound is smooth, homogeneous. 3 cases of pregnancy, pregnancy in 1 year after surgery, have full-term delivery. Conclusion Hysteroscopic resection of uterine fibroids is safe and feasible, but must choose a good type of fibroids before surgery, size, intraoperative attention to surgical skills and good care.