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1、【摘要】目的探讨利用宫腔镜手术治疗子宫内膜息肉(endometrialpolyps,EP)的临床价值。方法对2002年6月～2005年6月153例EP患者，按照妇女生理阶段、生育要求及临床症状，采用不同的宫腔镜手术方式治疗，回顾性分析治疗效果。其中生育期EP59例，围绝经期EP73例，绝经后期EP21例。患者年龄22～76岁，平均随访（22±6）个月。结果153例中，EP切除后遍刮内膜42例，遍刮内膜再施以内膜剥除13例，同时行浅层内膜切除26例，同时行全层内膜切除72例。有月经改变100例，术后治愈93例，无效7例；无效中5例合并子宫腺肌病（4例药物治疗治愈，1例行子宫切除），2例合并子宫内
2、膜增殖症（行二次内膜电切治愈）。痛经30例，有效23例，无效7例；无效中6例药物治疗好转，1例行子宫切除。继发贫血32例，治愈28例，好转4例。不孕症9例，治愈率77.78%。结论（1）生育期：无明显月经改变的，切除EP后遍刮子宫内膜；有明显月经改变的，其中无生育要求且年龄＞40岁的，切除EP后再行全层内膜切除；其余均切除EP后再行浅层内膜切除。（2）围绝经期：无明显月经改变的，切除EP后遍刮子宫内膜；有明显月经改变的，切除EP后再行全层内膜切除。（3）绝经后期：无阴道出血的，切除EP后遍刮子宫内膜；有阴道出血的，同时行内膜剥除。 【关键词】子宫内膜息肉；宫腔镜电切术 Astudyonap
3、pliedvaluationofhysteroscopicsurgeryforendometrialpolyps ZHANGHong-wei,SHENRong,ZHANGLei. ShanghaiYangpuMaternityandChildHealthHospital,Shanghai200082,China 【Abstract】ObjectiveTodeterminetheclinicalvaluationofdifferentwaysofhysteroscopicsurgeryforendometrialpolyps.MethodsClinicaleffectswereanalys
4、edretrospectivelyontotal153patientsunderwentdifferentwaysofhysteroscopicsurgeryaccordingtowomenphysiologicalstages,thedesireoffertilityandclinicalsymptomsduringtheperiodofJune2002-June2005.Themeanfollowed-updurationwas22±6months.ResultsAmong153cases,afterpolypsresected,meantime42casesunderwentuterin
5、ecurettage,13casesunderwentuterinecuerttageandendometriaablation,26cases’superficiallayerofendometriawereresected,72cases’swholelayerofendometriawereresected.In100casesmenstrualchange,93caseswerecured,7caseswereinvalid.Of7invalidcases,5casescomplicatedbyadenomyosis(4casescuredthroughdrugs,1casecured
6、throughhysterectomy),2casescomplicatedbyendometrialhyperplasia(curedbyrepeatendometrialresection).In30casesdysmenorrhea,23caseswerevalid,7caseswereinvalid.Of7invalidcases,6casesrecoveredthroughdrugs,1casecuredthroughhysterectomy.In32casessecondaryanemia,28caseswerecured,4casesrecovered.Infertilitycu
7、reratewas77.78%(7/9).Conclusion(1)Fertilestage:uterinecurettageshouldbeundergoneforpatientswithoutmenstrualchangeafterpolypsresected;amongpatientswithmenstrualchange,wholelayerofendometriawereresected
