摘要
目的:探讨宫腔镜操作严重并发症的诊治及预防措施。方法:回顾性分析2001年10月到2009年7月两所医院宫腔镜操作1891例,其中宫腔镜检查术1159例,宫腔镜取IUD及电切手术732例。结果:35例发生严重并发症,占1.85%,其中宫腔镜检查术发生率为0.78%,治疗性宫腔镜手术发生率为3.55%。35例中子宫穿孔11例,其中有3例经腹腔镜下修补治愈;TURP综合征3例,其中1例经ICU抢救治愈;出血5例,其中3例经球囊尿管压迫止血;盆腔感染8例,其中1例盆腔脓肿经腹腔镜手术治愈;宫腔粘连10例,全部经二次分粘后放置IUD同时人工周期治疗。结论:宫腔镜电切术早期出血用球囊尿管压迫止血效果好;严格控制手术时间是预防TURP综合征的重要环节;腹腔镜或B超监测是避免和及时发现穿孔的有效措施。
Objective：To investigate the diagnosis and treatment of serious complications in the hysteroscopic surgery and its preventive measures. Methods： 1891 cases of hysteroscopic operation were retrospective analyzed in two hospitals from Oct. 2001 to July 2009, in which there were 1159 cases of hysteroscopy, 732 cases of removal of IUD and surgical resection. Results： Among 35 cases of serious complications（ 1.85% ）, the incidence in hysteroscopy was 0.78%, in hysteroscopic surgery was 3.55%. In the 35 cases there were 11 cases ofuterine perforation, in which 3 cases were cured by laparoscopic repair.3 cases of transurethral resection of the prostate （TURP） syndrome, in which 1 case were given emergency treatment in ICU and cured.5 cases of hemorrhage, in which 3 cases got hemostasis by balloon catheter. 8 cases of pelvic infection, including 1 case of pelvic abscess were cured by isparoscopic surgery. 10 cases of intrauterine adhesions, all of them got secondary adhesions separation, then placed IUD with the artificial cycle treatment at the same time. Conclusions： It is effective to insert a balloon catheter to stop uterine bleeding in resection. Stdct control of operative time is an important pert of prevention of TURP syndrome. It is an effective means to avoid and discover the uterine perforation by laparoscope or B ultrasound.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2009年第10期615-617,共3页
Journal of Practical Obstetrics and Gynecology
关键词
宫腔镜检查
宫腔镜手术
并发症
Hysteroscopy
Hysteroscopic surgery
Complications
