【摘要】：本文報道1例36歲患者,重度貧血、子宮巨大壁間內(nèi)突肌瘤,給予口服小劑量米非司酮預(yù)處理12.5 mg,每日1次,連續(xù)5個月。持續(xù)閉經(jīng)5個月,無不適癥狀,貧血糾正后B超監(jiān)護下宮腔鏡先下后上法在肌瘤假包膜內(nèi)電切、鉗夾、牽引、旋轉(zhuǎn),清除8 cm×9 cm子宮巨大壁間內(nèi)突肌瘤,重約160 g,手術(shù)時間110 min。術(shù)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。術(shù)后病理:子宮平滑肌瘤,富含細(xì)胞。術(shù)后2 d順利出院。術(shù)后3個月患者月經(jīng)量仍多,宮腔鏡檢查提示:在原電切位置再次生長一6 cm×7 cm球形腫物,經(jīng)陰道行子宮全切術(shù)。術(shù)后病理示子宮平滑肌瘤,富含細(xì)胞,子宮內(nèi)膜呈分泌期改變,子宮頸慢性炎。我們認(rèn)為術(shù)前每日口服12.5 mg米非司酮3~5個月,可以明顯降低宮腔鏡電切直徑5 cm的子宮黏膜下肌瘤或子宮壁間內(nèi)突肌瘤的手術(shù)難度及風(fēng)險。
[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.
【作者單位】： 廣東省佛山市婦幼保健院宮腔鏡診治中心;廣東省佛山市婦幼保健院B超室;廣東省佛山市婦幼保健院麻醉科;廣東省佛山市婦幼保健院病理科;
【分類號】：R737.33

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