CAJ | 학술논문

目的分析选择性宫腔镜下子宫内膜切除术治疗月经过多型排卵型功血的临床疗效。方法86例月经过多患者，随机分入选择性子宫内膜切除术（治疗组）和传统子宫内膜切除术（对照组），治疗组仅对有病理意义的不规则增厚内膜行手术切除，在手术时间、术后出血、月经过少及闭经、经期腹痛和术后宫腔粘连的发生等方面观察治疗效果。结果治疗组有效率为77.9％，平均手术时间为(22.1±11.2)min，显著低于对照组的(45.6±14.1)min(P<0.01)，不良反应方面，治疗组术后出血过多、经期腹痛发生率与对照组相比无差异，但月经过少及闭经发生率为4.21％，明显低于对照组的41.5％(P<0.05)。术后发生宫腔粘连率为3.9％，显著低于传统术式的27.8％(P<0.05)。结论选择性子宫内膜切除术后不良并发率明显低于传统术式，是对传统子宫内膜切除术的有效改良术式，值得临床推广应用。
목적분석선택성궁강경하자궁내막절제술치료월경과다형배란형공혈적림상료효。방법86례월경과다환자，수궤분입선택성자궁내막절제술（치료조）화전통자궁내막절제술（대조조），치료조부대유병리의의적불규칙증후내막행수술절제，재수술시간、술후출혈、월경과소급폐경、경기복통화술후궁강점련적발생등방면관찰치료효과。결과치료조유효솔위77.9％，평균수술시간위(22.1±11.2)min，현저저우대조조적(45.6±14.1)min(P<0.01)，불량반응방면，치료조술후출혈과다、경기복통발생솔여대조조상비무차이，단월경과소급폐경발생솔위4.21％，명현저우대조조적41.5％(P<0.05)。술후발생궁강점련솔위3.9％，현저저우전통술식적27.8％(P<0.05)。결론선택성자궁내막절제술후불량병발솔명현저우전통술식，시대전통자궁내막절제술적유효개량술식，치득림상추엄응용。
Objective to observe the clinical curative ef ects of resecting endometrium under the selective uteroscope to treat the excessive menstruation and ovulatory dysfunetional hemorrhage. Method randomly selected 86 samples of patients suf ering from the excessive menstruation and divided them into two groups, treatment groups and control groups. In treatment groups the selective endometrium excision were used and in the tradition groups the traditional endometrium excision were used as the control groups. In the treatment groups only the thickening irregular pathological endometrium were excised. Observed the curative ef ects during the surgeries, and after the surgeries observed the symptoms of the hemorrhage, the oligomenorrhea , the menopause, abdominal pain in the menstrual period and the uterine cavity adhesion and so on. Result In treatment group the ef ective percentage is 77.9%, and the average procedure is 22.1±11.2 minutes. Obviously it is lower than the control group which is 45.6±14.1 minutes (P<0.01) . As to the adverse reactions, after the surgeries the symptoms of the hemorrhage and the abdominal pain in the menstrual period are the same between the treatment groups and the control groups. But the incidence of the oligomenorrhea and the menopause is 4.21%, obviously it is lower than the incidence of control group which is 41.5% (P<0.05). The incidence of uterine cavity adhesion is 3.9%, obviously it is lower than the incidence of control group which is 27.8% (P< 0.05). Conclusion obviously using the selective endometrium excision the incidence of adverse reactions is lower than using the traditional technique type, and the selective endometrium excision is an improvement in the traditional excision, and it is worth recommending to the clinical application.