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Severe complications of hysteroscopic surgeries: an analysis of 35 cases
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF OBSTETRICS AND GYNECOLOGY
- Issue:
- 10
- DOI:
- 10.3760/j.issn:0529-567X.2001.10.005
- Key Word:
- 官腔镜检查;电外科手术;子宫穿孔;手术后并发症
Abstract： 目的探讨行宫腔镜检查和官腔镜电切术发生严重并发症的早期诊断、治疗及预防.方法对12 921例患者行官腔镜检查,同时行B超扫描;对2 221例患者行官腔镜电切术,同时行B超或腹腔镜监护.结果发生严重并发症35例,其中出血9例,经宫腔球囊置入、电凝、填塞或子宫体切除治愈;子宫穿孔11例,经保守治疗、腹腔镜或子宫切除治愈;空气栓塞1例,经抢救存活;术后感染4例,经抗生素治疗治愈;尿道电切前列腺(TURP)综合征5例,经利尿及静脉输注盐水治愈;子宫内膜去除-输卵管绝育术后综合征(PASS)4例,经扩宫、排出积血,行宫腔粘连或子宫切除治愈;术后8年发生子宫内膜癌l例,再次手术治疗.结论行宫腔镜检查,以球囊压迫官腔可有效控制出血;应注意B超和腹腔镜监护不能完全防止子宫穿孔;控制灌流液压力和手术时间,可减少TURP综合征的发生.行宫腔镜电切术后应加强随访,早期发现PASS和子宫内膜癌.避免空气栓塞的发生.
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