摘要
目的评价子宫内膜电切术诊断和治疗子宫内膜不典型增生(endometrialatypicalhyperplasia,EAH)的价值。方法对实施子宫内膜电切术的26例EAH患者的临床特点,术中、术后和预后情况进行回顾性分析。结果患者平均年龄43.5岁,平均手术时间(24.7±10.3)min;平均术中出血(43.1±11.7)mL。无死亡、子宫穿孔、低钠血症及电损伤等并发症发生。随访3.7(a1～7a),术后闭经21例(80.8%),少量月经2例(7.7%),闭经4个月后再次周期性子宫出血3例(11.5%),但月经量均少于平常正常量。2例TCRE术后先后行子宫切除术,剖视宫腔无内膜残留。诊刮与电切之间诊断EAH的符合率为65.4%。结论对没有生育要求,能够坚持随访的患者,子宫内膜电切术可以替代传统的子宫切除术治疗EAH,并有利于早期发现和诊断子宫内膜癌及其癌前病变,具有不开腹、创伤小、出血少、卵巢功能和性生活影响小等优点。
[Objective] To evaluate the role of transcervical resection of endometrium in the diagnosis and treatment of women with endometrial atypical hyperplasia. [Methods] We conducted a retrospective analysis of operation time, blood loss, complications and prognosis of 26 cases of resectoscopic surgery for endometrial intraepithelial neoplasia. [Results] The mean age of 26 patients was 43.5. The average operation time was （24.7：l：10.3）min. The average blood loss is （43.1：1：11.7）mL. No death, uterine perforation, hyponatremia and electric injury was observed. 26 patients were followed for 1 to 7 years, twenty-one women （80.8%） were amenorrhoeic. Two patients had only spotting, cycling little bleeding relapsed in three additional patients with amenorrhea 4 months or more later. Two patients received hysterectomy. No residual endometrlum was found in hysterectomy specimens. The coincidence rate of diagnosis of endometrial atypical hyperplasia was 65.4% between curettage and electroresection. [Conclusions] Skillful surgery like transcervical resection of endimetrium may be an alternative to hysterectomy in selected patients with endometrial atypical hyperplasia who do not have a demand for pregnancy and are compliant with regular and long-term follow-uo.
出处
《中国内镜杂志》
CSCD
北大核心
2006年第6期587-589,共3页
China Journal of Endoscopy
关键词
宫腔镜
电外科手术
子宫内膜不典型增生
预后
hysteroscope
electrosurgery
endometrial atypical hyperplasia
prognosis
