摘要
目的探讨宫腔镜电切术过度水化综合征(TURP综合征)的发生原因、诊断、处理和预防措施.方法对2000年1月～2003年12月中宫腔镜电切术发生过度水化综合征的5例患者进行临床分析.结果子宫肌瘤电切术3例,肌瘤直径＞5 cm,均为内凸型,约2/5位于肌壁内,术中肌层破坏面积大;子宫内膜电切术1例,因患者子宫过度后屈,宫腔深达9.5 cm,手术难度大,内膜创面广;宫腔重度粘连电切术1例,宫腔重度肌性粘连,分离后大量血管暴露,创面大.5例经补钠、利尿处理后,症状均得到控制.结论过度水化综合征的发生与复杂的宫腔操作导致的子宫内膜、肌层的破坏程度有关.早期诊断治疗,预后良好.而缩短手术时间,控制宫腔压力,减少灌流液的吸收则是预防其发生的关键.
Objective:To analyze the cause,diagnosis,treatment and preventive methods on transurethral resection of prostate(TURP)syndrome of the hysteroscopic electroresection.Methods:5cases of TURP during the hysteroscopic electroresection,which took place from January2000to December2003,were clinical analyzed.Rusults:There were3cases of transcervical resection of myoma(TCRM).The size of myomas in diameter was bigger than5cm,which were intramurul myoma of protrusive uterine cavity,2/5in the muscle.So the destroyed myometrium is extensive.1case of transcervical resection of endometrium(TCRE),because of retroversioflexion of the uterine,depth of uterine cavity was9.5cm,the resection was very difficult,and myometrium was destroyed extensively.1case of transcervical resection of uterine adhersion,with the extensive myogenic adhersion,many blood vessel were exposured.The5cases were cured by saline infusion and diuretic agent,there were no serious consequence happened.Conclusions:TURP syndrome was induced by the complicated procedures inside uterine cavity.The earlier diagnosis are helpful to favorable prognosis.It's the key method to prevent TURP syndrome by controlling operating time,the pressure in the uterine cavity and the absorption of irrigating flow.
出处
《中国内镜杂志》
CSCD
2004年第8期48-50,共3页
China Journal of Endoscopy
关键词
过度水化综合征
电外科手术
灌流液
宫腔压力
hyperhydration syndrome
electrosurgery
Irrigating flow
pressure in uterine cavity
