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目的:探讨超声监护在宫腔镜电切术中的应用价值。方法:对102例患者施行超声监护下宫腔镜手术,其中经宫颈子宫内膜切除术(TCRE)56例,经宫颈子宫肌瘤切除术(TCRM)25例,经宫颈子宫腔内异物切除术(TCRF)8例,经宫颈子宫纵隔切除术(TCRS)8例,经宫颈子宫腔内粘连切开术(TCRA)5例。结果:术中检查宫腔深度6~12 cm,平均(7.8±1.6)cm,手术时间8~40 min,平均(18.96±1.60)min,出血量25~32 ml,平均(28.16±1.12)ml,住院时间2~6 d,平均(4.6±1.2)d。术中胎盘植入致子宫穿孔转开腹1例,其余均顺利完成手术。81例行TCRE、TCRM术式患者中随访77例,月经闭经11例,阴道点滴出血17例,月经量减少28例,月经无改变17例,月经改善达77.9%。结果:在宫腔镜手术中应用超声监护对提高手术成功率、减少术后并发症的发生具有重要的临床应用价值。
Objective: To explore the value of ultrasonic monitoring in hysteroscopic resection. Methods: Totally 102 patients underwent hysteroscopy under ultrasound monitoring. Among them, 56 cases were treated by endometriosis (TCRE), 25 cases by cervical hysteromyoma (TCRM), and 25 cases by cervical uterine cavity excision (TCRF) in 8 cases, cervical uterine segment mediastinal resection (TCRS) in 8 cases and cervical intrauterine adhesions (TCRA) in 5 cases. Results: Intrauterine examination showed that the depth of uterine cavity was 6 ~ 12 cm (mean, 7.8 ± 1.6) cm, operation time was 8 ~ 40 min, average was (18.96 ± 1.60) min, hemorrhage was 25 ~ 32 ml , Hospital stay of 2 ~ 6 d, an average of (4.6 ± 1.2) d. Intraoperative placenta accreta into the uterine perforation to 1 case of open laparotomy, the rest were successfully completed surgery. Eighty-one patients with TCRE and TCRM were followed up 77 cases, 11 menstruation amenorrhea, 17 cases of vaginal bleeding, 28 cases of menstrual flow reduction, 17 cases of no menstruation, 77.9% improvement of menstruation. Results: The application of ultrasound monitoring in hysteroscopic surgery has important clinical value in improving the success rate of operation and reducing the incidence of postoperative complications.