论文部分内容阅读
目的探讨B超监护下宫腔镜下子宫肌瘤电切术术中止血效果及预后。方法对中心2012年1~10月期间122例子宫肌瘤患者进行TCRM手术,术中有B超监护。122例患者中0型、I型子宫肌瘤72例,II型子宫肌瘤32例,多发黏膜下肌瘤及肌壁间肌瘤10例,宫颈肌瘤8例,切除后双击电凝止血+瘤窝采用球囊压迫止血21例,双击电凝止血97例,汽化电极止血4例。结果 122例患者平均年龄39.90±9.56岁,宫腔深度8.3±1.4cm(7~12cm),切除肌瘤最大直径7.5cm,手术平均出血量28.84±36.01ml,无术后输血者。手术均一次成功,术后4例一过性发热,术后1日阴道出血量少于平素月经第一日水平,3例术后6小时阴道出血仍多,增加球囊压迫力度及时间,予止血药后好转,术后月经减少0、I型及宫颈肌瘤患者100%、II型患者93.9%、多发肌瘤伴有肌壁间的81.8%,术后脱痂出血少于月经量者98.4%。结论 TCRM术治疗黏膜下肌瘤、肌壁间肌瘤安全、有效。术中止血方式均有效,术后恢复效果好。
Objective To investigate the effect and prognosis of hemostasis in hysteroscopic uterine myoma resection under B-ultrasound. Methods A total of 122 patients with uterine fibroids underwent TCRM during the period from January to October in 2012 with B-ultrasound during operation. 122 cases of type 0, type I uterine fibroids in 72 cases, type II uterine fibroids in 32 cases, multiple submucosal fibroids and intramural fibroids in 10 cases, 8 cases of cervical fibroids, double-click after removal of coagulation and coagulation + Tumor litter with balloon hemostasis in 21 cases, 97 cases double coagulation hemostasis, 4 cases of vaporization electrode hemostasis. Results The average age of 122 patients was 39.90 ± 9.56 years. The depth of uterine cavity was 8.3 ± 1.4cm (7 ~ 12cm). The maximum diameter of myomectomy was 7.5cm. The average amount of bleeding was 28.84 ± 36.01ml. There was no postoperative blood transfusion. Surgery were a success, postoperative 4 cases of transient fever, vaginal bleeding on the 1st postoperative day less than the level of normal menstruation, 3 cases of postoperative vaginal bleeding 6 hours still more to increase the intensity and time of balloon compression, to Hemostasis improved after surgery, menstrual reduction 0, 100% of type I and cervical fibroids, 93.9% of type II patients, multiple myxomas with muscle wall 81.8%, after surgery off scab bleeding less than menstrual flow 98.4 %. Conclusion TCRM treatment of submucosal fibroids, intramural fibroids safe and effective. Intraoperative hemostasis are effective, good postoperative recovery.