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目的 :探讨电视宫腔镜电切术术前准备的合理方式。方法 :1 0 8例宫腔镜电切手术 ,术前全部患者行B超、宫腔镜检查并刮宫或活检标本作病理检查 ;子宫内膜切除术患者于月经周期早期手术 ,其余患者手术时机不限 ;术前宫腔插管或舌下含服 40 0 μg米索前列醇扩张宫颈。对手术时机、手术经过以及随访结果进行分析。结果 :子宫内膜切除术手术时间在月经第 4～ 7天 ,中位数第 5天 ;其余患者手术时间在月经周期第 5～ 2 8d ,中位数第 1 0天 ;1 1例绝经后出血患者于出血控制后手术。术前宫腔插管或舌下含服 40 0 μg米索前列醇均均能顺利通过 9号Hegar扩张器。 98例子宫内膜切除术、子宫粘膜下肌瘤切除、子宫内膜息肉切除术手术时间2 9.2± 1 7.9min(5～ 95) ,有效率 95 .8% ;1 0例腹腔镜下子宫纵隔切开术手术时间 61 .0± 9.7min(50～80min) ,术后 2例妊娠。结论 :B超、宫腔镜检查是宫腔镜手术前必要的评估手段 ;电视宫腔镜电切术不作术前预处理是可行的。米索前列醇术前扩张宫颈效果好。
Objective: To investigate the reasonable way of hysteroscopic electrotomy for preoperative preparation. Methods: One hundred and eight cases underwent hysteroscopic resection. All the patients underwent preoperative B-mode ultrasonography, hysteroscopy and curettage or biopsy for pathological examination. The endometrial resection was performed in the early stage of menstrual cycle, Not limited; Preoperative uterine intubation or sublingual 40 0 micrograms of misoprostol to expand the cervix. The timing of surgery, surgery and follow-up results were analyzed. Results: The operation time of endometrial ablation was on the 4th to 7th days of menstruation, the 5th day on the median. The rest time of operation was between the 5th and 28th days of the menstrual cycle and the median of 10 days. Bleeding patients underwent surgery after bleeding control. Preoperative uterine intubation or sublingual 40 0 micrograms of misoprostol were able to successfully through the No. 9 Hegar dilator. 98 cases of endometrial resection, resection of uterine submucous myoma, endometrial polyps resection operation time of 2 9.2 ± 1 7.9min (5 ~ 95), 95.8% efficiency; 10 cases of laparoscopic uterine mediastinum Incision operation time 61. ± 9.7min (50 ~ 80min), 2 cases of pregnancy. Conclusion: B-ultrasound and hysteroscopy are the necessary evaluation methods before hysteroscopic surgery. It is feasible that TV-hysteroscopic resection without preoperative treatment. Misoprostol good preoperative cervical expansion.