CAJ | 학술논문

目的：总结宫腔镜子宫内膜电切术后晚期并发症的临床特点和治疗经验。方法2006年1月～2014年6月13例因功能失调性子宫出血行宫腔镜子宫内膜电切术后（＞9年）出现晚期并发症，再次宫腔镜探查并处理。结果13例宫腔镜二次探查结果：6例宫腔积血，其中4例位于宫角，2例位于宫腔；7例局灶或四壁内膜增生，其中1例出现子宫内膜去除-输卵管绝育术后综合征，1例子宫内膜病理为非典型增生Ⅰ级。7例术后症状好转（53．8％）；3例合并子宫腺肌病继发进行性痛经（23．1％），2例子宫内膜增殖有乳腺癌手术史（15．4％），1例子宫内膜非典型增生Ⅰ级（7．7％）均行腹腔镜下全子宫切除术。结论宫腔镜子宫内膜电切术后残存有功能的子宫内膜或日后再生的内膜可引起晚期并发症，需要临床进一步诊治。
목적：총결궁강경자궁내막전절술후만기병발증적림상특점화치료경험。방법2006년1월～2014년6월13례인공능실조성자궁출혈행궁강경자궁내막전절술후（＞9년）출현만기병발증，재차궁강경탐사병처리。결과13례궁강경이차탐사결과：6례궁강적혈，기중4례위우궁각，2례위우궁강；7례국조혹사벽내막증생，기중1례출현자궁내막거제-수란관절육술후종합정，1례자궁내막병리위비전형증생Ⅰ급。7례술후증상호전（53．8％）；3례합병자궁선기병계발진행성통경（23．1％），2례자궁내막증식유유선암수술사（15．4％），1례자궁내막비전형증생Ⅰ급（7．7％）균행복강경하전자궁절제술。결론궁강경자궁내막전절술후잔존유공능적자궁내막혹일후재생적내막가인기만기병발증，수요림상진일보진치。
Objective To analyze clinical characteristics and treatment experience for late complications after hysteroscopic transcervical resection of endometrium ( TCRE) . Methods Clinical data of 13 cases of late complications after hysteroscopic TCRE for dysfunctional uterine bleeding from January 2006 to June 2014 were retrospectively analyzed .A re-operation of hysteroscopic exploration and resection were required . Results The re-operation in the 13 patients found 6 cases of hematocele in uterine cavity (4 cases in the uterine horn, 2 cases in the uterine cavity) and 7 cases of focal or whole uterine endometrial hyperplasia (including 1 cases of PASS syndrome and 1 case of endometrial pathology of grade Ⅰatypical hyperplasia ) .Postoperative symptoms were relieved in 7 cases (53.8%).Laparoscopic total hysterectomy was performed in 3 cases of adenomyosis complicated with secondary progressive dysmenorrhea (23.1%), 2 cases of endometrial proliferation associated with a breast cancer history (15.4%), and 1 case of endometrial atypical hyperplasia grade Ⅰ (7.7%). Conclusion After hysteroscopic TCRE, residual functional endometrium or future regeneration of endometrium may lead to late complications , which need further clinical diagnosis and treatment .