【摘要】 目的　研究宫腔镜下诊断和Nd∶YAG激光治疗子宫内膜息肉的有效性和可行性。方法　门诊可疑子宫内膜息肉患者 38例 ,其中主诉月经过多 12例、不规则阴道流血 14例、经期延长 8例、阴道排液 1例及无临床症状 3例。 38例子宫内膜息肉切除均采用Nd∶YAG激光在宫腔镜下手术。激光功率 30W ,光斑直径 2mm ,照射时间 1～ 5min。经宫腔镜操作孔置入石英光纤至宫腔 ,汽化切割息肉体部或息肉蒂部。结果　所有手术均顺利进行 ,宫腔深度 8 0cm± 1 5cm(7～ 10cm) ,手术时间平均 5 0min± 10 2min。 38例子宫内膜息肉激光汽化均一次手术成功 ,术中术后无一例发生严重并发症 ,临床治愈率为 94 3 %。经妇科检查、B型超声等随访 1～ 3个月 ,宫腔内赘生物均消失。结论　对诊刮不能明确或诊刮后仍有宫腔赘生物的患者 ,应行宫腔镜检查。Nd∶YAG激光治疗子宫内膜息肉是安全有效的治疗手段更多还原

【Abstract】 Objective To investigate the effectiveness and feasibility of hysteroscopic diagnosis and Nd∶YAG laser ablation of endometrial polyps. Methods A total of 38 patients with endometrial polyps were included in this group, recruited from the outpatient department of Obstetrics and Gynecology Hospital of Shanghai Medical University during the period from May 1996 to August 1999. Among them there were 12 cases with menorrhagia, 14 with irregular vaginal bleeding, 8 with prolonged menstrual period, 1 vaginal discharge and 3 cases had no clinical symptom. 38 hysteroscopic Nd∶YAG laser polypectomies were performed. Results All surgical operations were completed successfully. The average uterine depth was 8 0 cm±1 5 cm(7-10 cm) and the average operative time was 5 0 min±10 2 min. All 38 polypectomies were succeded without repeated surgery. No serious complications occurred during or after operation. The clinical curative rate was 94 3%, the intrauterine neoplasms disappeared in all cases during a follow up period of 1-3 month. Conclusions The above described results indicate that for those endometrial polyps which are unclearly diagnosed or incompletely removed by dilation and curettage, hysteroscopic examination is of great significance and indispensable. For patients having diagnosed endometrial polyps hysteroscopic Nd∶YAG laser ablation is an effective and safe approach of treatment.更多还原