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目的:探讨电视宫腔镜电切术治疗子宫内膜病变的临床疗效。方法:640例子宫内膜病变患者,其中子宫内膜息肉326例,功能性子宫出血188例,子宫肌瘤126例,对640例患者采用宫腔镜进行治疗。根据患者生育要求及对月经的要求不同,116例采用子宫内膜病变切除+子宫内膜汽化电切术,368例采用子宫内膜病变电切+子宫内膜切除术,81例采用子宫内膜病变电切+子宫内膜浅层电切术,绝经妇女75例单纯行病灶切除。结果:随访3个月,640例电切术后597例(93.3%)月经改善;随访5~66个月,平均(38±5)个月,月经改善达81.4%~93.3%。不同手术方式与月经改善情况无明显关系(P>0.05)。565例子宫内膜病变育龄期患者中,无生育要求者484例用汽化电切手术时间平均(11.24±0.26)min,子宫内膜电切手术时间平均(20.12±0.46)min,2种术式手术时间差异有统计学意义(P<0.05);26例不孕患者中有19例术后妊娠;282例子宫内膜息肉育龄期妇女,对要求保留生育功能患者,切除息肉及息肉旁组织和功能层内膜,术后无闭经者,但术后息肉复发高于汽化电切及子宫内膜电切。结论:宫腔镜电切术治疗子宫内膜病变具有极高的临床价值,是子宫内膜病变首选的治疗方法,根据患者生育要求及对月经的要求不同采用的手术方式。
Objective: To investigate the clinical efficacy of hysteroscopic electrotomy for endometrial lesions. Methods: Sixty-four patients with endometrial lesions, including 326 cases of endometrial polyps, 188 cases of functional uterine bleeding and 126 cases of uterine fibroids, were treated with hysteroscopy in 640 patients. According to the patient’s requirements and menstrual requirements of different, 116 cases of endometrial lesion resection + endometrial vaporization resection, 368 cases of endometrial resection with endometrial resection, 81 cases of endometrial Tumor resection + endometrial superficial resection, 75 cases of menopause women simple excision lesion. Results: During the follow-up period of 3 months, 597 (93.3%) of 640 patients underwent resection. The follow-up was from 5 to 66 months with an average of (38 ± 5) months and the improvement of menstruation reached 81.4% to 93.3%. There was no significant relationship between different surgical methods and menstrual improvement (P> 0.05). Of the 565 cases of endometrial disease of childbearing age, 484 cases without reproductive requirements were treated with vaporization and electrosurgical resection (11.24 ± 0.26) min, the average time of endometrial resection was (20.12 ± 0.46) min, two kinds of operation There were statistically significant differences in operative time (P <0.05); among 26 infertile patients, 19 had postoperative pregnancy; 282 women of childbearing age with endometrial polyps had no significant effect on the patients requiring fertility maintenance, Functional endothelium, no menopause after surgery, but postoperative polyp recurrence higher than the vaporization and endometrial resection. Conclusion: Hysteroscopic resection of endometrial lesions with high clinical value, is the preferred treatment of endometrial lesions, according to the requirements of patients with menstrual requirements and the use of different surgical methods.