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[目的]观察和探讨宫腔镜下黏膜下子宫肌瘤电切术(TCRM)的临床疗效及可行性。[方法]对2008年1月~2011年1月收治的45例子宫肌瘤患者采取宫腔镜下黏膜下子宫肌瘤电切术,观察比较患者治疗前后血红蛋白含量及血清钠水平,术后随访所有患者1年,观察手术效果。[结果]本组45例患者,44例手术均较成功,1例(2.22%)患者发生子宫穿孔;术后回访1年,42例(93.33%)患者恢复良好,无任何异常情况,3例(6.67%)发生子宫异常出血,其中2例经对症处理,症状消失,1例肌瘤复发患者行子宫全切术;患者术前1 d血红蛋白为(91.5±13.6)g/L,术后d 7血红蛋白为(105.3±6.9)g/L,治疗前后差异有统计学意义(P﹤0.05);术前1 d血清钠为(141.2±6.6)mmol/L;术后d 3血清钠为(139.3±5.4)mmol/L,治疗前后差异无统计学意义(P﹥0.05)。[结论]宫腔镜下黏膜下子宫肌瘤电切术治疗子宫肌瘤手术创伤小,手术时间短,术后并发症少,患者恢复快,疗效显著,可行性高,是子宫肌瘤患者尤其是有生育要求的育龄妇女理想的选择。
[Objective] To observe and discuss the clinical efficacy and feasibility of hysteroscopic submucosal uterine leiomyomactomy (TCRM). [Method] Forty-five patients with uterine fibroids admitted to our hospital from January 2008 to January 2011 were treated with hysteroscopic submucosal uterine myoma resection. The levels of hemoglobin and serum sodium before and after treatment were observed and compared between the two groups All patients for 1 year, observe the effect of surgery. [Results] Forty-five patients in our study were successful in 44 cases. Uterine perforation occurred in 1 patient (2.22%). One year after the operation, 42 patients (93.33%) recovered well without any abnormality and 3 patients (6.67%) had abnormal uterine bleeding. Among them, 2 cases were symptomatically treated and their symptoms disappeared. One case of myoma recurrence was treated by hysterectomy. The hemoglobin was (91.5 ± 13.6) g / (105.3 ± 6.9) g / L, the difference was statistically significant before and after treatment (P <0.05); the level of serum sodium was (141.2 ± 6.6) mmol / L on the first day before operation; ± 5.4) mmol / L, there was no significant difference between before and after treatment (P> 0.05). [Conclusion] Hysteroscopic submucosal uterine myoma resection of hysteromyoma surgical trauma, shorter operative time, fewer postoperative complications, rapid recovery of patients, significant effect, the feasibility of high, especially in patients with uterine fibroids It is an ideal choice for women of childbearing age who have reproductive requirements.