宫腔镜下切除子宫巨大壁间内突肌瘤1例报告

发布时间：2018-12-13 15:30

【摘要】：本文报道1例36岁患者,重度贫血、子宫巨大壁间内突肌瘤,给予口服小剂量米非司酮预处理12.5 mg,每日1次,连续5个月。持续闭经5个月,无不适症状,贫血纠正后B超监护下宫腔镜先下后上法在肌瘤假包膜内电切、钳夹、牵引、旋转,清除8 cm×9 cm子宫巨大壁间内突肌瘤,重约160 g,手术时间110 min。术中使用5%葡萄糖灌流液20 000 ml,灌流液吸收量600 ml,出血400 ml。术后病理:子宫平滑肌瘤,富含细胞。术后2 d顺利出院。术后3个月患者月经量仍多,宫腔镜检查提示:在原电切位置再次生长一6 cm×7 cm球形肿物,经阴道行子宫全切术。术后病理示子宫平滑肌瘤,富含细胞,子宫内膜呈分泌期改变,子宫颈慢性炎。我们认为术前每日口服12.5 mg米非司酮3~5个月,可以明显降低宫腔镜电切直径5 cm的子宫黏膜下肌瘤或子宫壁间内突肌瘤的手术难度及风险。
[Abstract]:A 36-year-old patient with severe anemia and giant intramural myoma of the uterus was treated with oral low-dose mifepristone once a day for 5 months. Continuous amenorrhea for 5 months, no symptoms, hysteroscopy under B-ultrasound monitoring after correction of anemia in the pseudocapsule electroresection, clamp, traction, rotation, removal of 8 cm 脳 9 cm giant intramural myoma, weighing about 160g, Operation time 110 min. Intraoperative use of 5% glucose perfusion fluid 20 000 ml, perfusion fluid absorption 600 ml, bleeding 400 ml. Postoperative pathology: uterine leiomyoma, rich in cells. The patients were discharged 2 days after operation. After 3 months, the menstrual volume of the patients was still more. Hysteroscopy showed that a 6 cm 脳 7 cm spherical tumor was again grown at the original position of electroresection, and transvaginal hysterectomy was performed. Postoperative pathology showed uterine leiomyoma, rich in cells, endometrial secretory phase changes, chronic cervicitis. We believe that oral administration of 12.5 mg mifepristone for 3 ~ 5 months before operation can significantly reduce the difficulty and risk of hysteroscopic resection of submucous myoma or intramural myoma with 5 cm diameter by hysteroscopy.
【作者单位】：广东省佛山市妇幼保健院宫腔镜诊治中心;广东省佛山市妇幼保健院B超室;广东省佛山市妇幼保健院麻醉科;广东省佛山市妇幼保健院病理科;
【分类号】：R737.33

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