Evaluation Of The Clinical Effect Of The Hysteroscopic Treatment Of Submucous Myoma Using HEOS

Objective: Uterine fibroids are the most common solid tumors in the uterus,including menorrhagia and uterine bleeding,leading to anemia,dysmenorrhea and / or abdominal pain,lumbosacral pain,infertility and premature delivery.More common in women aged 40-50,it can also be seen in young women,causing severe bleeding and infertility,through the analysis of less than 3cm of submucosal uterine fibroids in patients with clinical data,clinical efficacy and safety of cutting fibroids in hysteroscopic surgery for uterine submucosal hysteroscopic cold knife,improve operation accuracy,to formulate the reasonable treatment scheme evidence support.Methods: The 65 cases from Liu Zhou gynecological hospital gynecology since January 2014 to December 2015 by the same surgical doctor,which in condition of myoma in less than 3cm in diameter underwent hysteroscopic surgery treatment of type 0,type I,type II.Operation index(operation time,fluid volume,bleeding volume and complications)and the treatment effect(symptom improvement,myoma resection and postoperative satisfaction rate)were retrospectively analyzed,including 31 cases of hysteroscopy cold scissors group,34 cases of hysteroscopic resection group,all patients with clinical data were collected and analyzed statistically.Results: 1.Operation index The patients were divided into two groups.The patients were divided into two groups,one was treated with hysteroscopy cold scissors and the other was treated with hysteroscopic resection.Hysteroscopy cold cut operation time(36.61±13.71)min,and hysteroscopic group(39.33±16.11) compared to the min,there was no statistically significant difference(P > 0.05);hysteroscopy uterine fluid volume cold cut group(3425.16±1256.34)ml,hysteroscopic group(3630.62 ±1365.12)ml,two in the group of uterine distention liquid dosage had no significant difference(P > 0.05).2.Type 0 of submucosal myoma in the comparison of the two different surgical methods can be found,cold cut group operation time and intraoperative blood loss were less than the group,there was no significant difference in the amount of uterine distention and absorption.There was no significant difference in the operation time between the cold cut group and the electric resection group.However,there were significant differences between the two groups in the amount of frozen uterine fluid,the amount of absorption and intraoperative bleeding,the difference was statistically significant(P < 0.05).3.Follow-up 61 patients were followed up,and 4 patients were lost to follow-up.The abdominal pain rate of cold cut group was lower than that of transurethral resection group,and the number of days of vaginal discharge was less than that of the group.After the third menstrual cycle menstrual clean after 3~7 days hysteroscopy,cold cut group have normal uterine cavity shape,the operation of the wound has a uniform coverage of the intima,tunica intima pink,smooth.There were 1 cases of scar in hysteroscopic incision group,and the other in the uterine cavity.The morphology of the remaining uterine cavity was normal,but the rate of intimal coverage was lower than that of cold cut group.One year after the operation,there were a total of 5 cases of recurrence,2 cases in the control group,and 3 cases in the group of electrical resection.4.Post-operative pregnancy There were 14 patients with fertility requirements,and the normal uterine cavity was normal in all the cases in the 3 months after operation,and the adhesion occurred in all the 13 cases after the operation in 1 cases.Cold cut group of 7 cases with fertility requirements of the natural pregnancy in 3 cases,in vitro fertilization embryo transfer(In-vitro fertilization embryo transfer and,IVF-ET)pregnancy.There were 6 cases in the incision group with fertility requirement,and the other one was pregnant in 1 cases,and the other one was IVF-ET,and the other one was not pregnant.Conclusion: 1.The treatment of submucous myoma of uterus by hysteroscopic cold cut is less bleeding and less absorption of uterine distention.For the type 0 submucosal myoma,hysteroscopic resection with cold transurethral resection of a short time,more efficient;for type I and type II submucous myoma,hysteroscopic resection in cold uterine fluid volume,uterine fluid absorption was less than TCRM.2.Hysteroscopic treatment of leiomyoma in less than 3cm of the submucous,cold knife surgery safer,less complications,endometrial damage,postoperative intrauterine rapid recovery,reduce the incidence of intrauterine adhesions,protect the reproductive function to the maximum extent,is the best choice for patients with uterine submucous myoma.