Serden S P, Brooks P G
Department of Obstetrics and Gynecology, University of California School of Medicine, Los Angeles.
J Reprod Med. 1991 Oct;36(10):697-9.
The gynecologic resectoscope, recently approved by the Food and Drug Administration for the treatment of abnormal uterine bleeding, was evaluated for its success in the treatment of women with this complaint. Through June 1990, 216 patients were treated with this modality. Ninety were treated with transcervical myomectomy alone since they still desired fertility preservation or wished to avoid hysterectomy. Of the patients treated, 189 (87.5%) had follow-up evaluation for at least three months and some as long as three years. Of the ninety patients treated with resection of a submucous myoma, greater than 90% had a marked improvement in their symptoms, with decreased menstrual bleeding. Of the 96 patients treated with endometrial ablation, 50% were amenorrheic, 26% had hypomenorrhea, 17% had eumenorrhea, and 7% were unimproved. There was only one case of fluid overload, and no patients required a blood transfusion. Complications included two cases of endometritis and one perforation at the time of retrieval of myoma fragments. Four patients required placement of a 30-mL Foley catheter for control of postoperative bleeding. Gynecologic resectoscopy is a safe and effective alternative to major surgery in the management of abnormal uterine bleeding for which conservative measures have not been effective.
妇科电切镜最近已获美国食品药品监督管理局批准用于治疗异常子宫出血，本文对其治疗有此症状女性的疗效进行了评估。截至1990年6月，共有216例患者接受了这种治疗方式。其中90例仅接受了经宫颈子宫肌瘤切除术，因为她们仍希望保留生育能力或避免子宫切除术。在接受治疗的患者中，189例（87.5%）接受了至少三个月的随访评估，部分患者的随访时间长达三年。在接受黏膜下子宫肌瘤切除术的90例患者中，超过90%的患者症状有明显改善，月经量减少。在接受子宫内膜切除术的96例患者中，50%闭经，26%月经过少，17%月经正常，7%无改善。仅出现1例液体超负荷情况，无患者需要输血。并发症包括2例子宫内膜炎和1例在取出肌瘤碎片时发生的穿孔。4例患者需要放置30毫升的Foley导管以控制术后出血。对于保守治疗无效的异常子宫出血，妇科电切镜是一种安全有效的替代大手术的治疗方法。
