目的:利用预测分析模型拟合宫腔镜黏膜下子宫肌瘤切除术的学习曲线,为基层医院开展宫腔镜下黏膜下子宫肌瘤切除术的学习过程提供参考.方法:收集66例行宫腔镜下黏膜下子宫肌瘤切除术病人,按照手术时间前后顺序进行编号,通过移动平均法分别根据术中出血量、手术时间拟合学习曲线,将病人分为第一阶段组(第1～20例,A组)和第二阶段组(第21～66例,B组),比较2组病人手术相关指标.结果:A组病人手术时间、术中出血量、住院时间均大于B组(P<0.05～P<0.01),2组术后并发症发生情况差异无统计学意义(P>0.05).2组病人术后月经恢复时间、月经量和术后1个月血红蛋白水平及术后随访妊娠结局差异均无统计学意义(P>0.05).结论:经过前20例宫腔镜黏膜下子宫肌瘤切除术学习阶段后,手术操作相对稳定,宫腔镜黏膜下子宫肌瘤切除术初学者应在前20例手术中严格把握适应证,熟练手术操作,学习处理突发情况,以更好地掌握手术技术.

Objective: To explore the clinical efficacy and safety of hysteroscopic electrotomy in the treatment of submucosal myoma of uterus.Methods: Forty-six patients with submucosal myoma of uterus were divided into hysteroscopic operation group(26 cases) and laparotomy group(20 cases).The time of operation,anal exhaust,ambulation and hospital stay,intraoperative blood loss and postoperative fever rate of two groups were analysed.Results: The operative time and intraoperative blood loss of hysteroscopic operation group were shorter or less than those in laparotomy group(P 0.01).The time of anal exhaust,ambulation and hospital stay of hysteroscopic operation group were significantly shorter than those in laparotomy group(P 0.01).The postoperative fever cases in hysteroscopic operation group and that in laparotomy group the difference was not statistical significance(P 0.05).Conclusions: Hysteroscopic electrotomy in the treatment of submucosal myoma of uterus is good clinical efficacy and safety,which can be the first choice of treatment means.

目的:探讨采用子宫捆绑术治疗剖宫产术中产后出血的临床疗效.方法:2011年6月至2012年10月我院对剖宫产术中因宫缩乏力引起产后出血的40例患者,采取子宫捆绑术治疗,对其临床资料进行回顾分析.结果:本组40例均成功止血,有效率为100％.术后患者子宫收缩佳,无再次大出血,无切口感染、宫腔感染等术后并发症发生,腹部切口均一期愈合.40例患者均获随访2～12个月,平均6.25个月.术后42 d复查,子宫均恢复正常.其中24例术后6～12个月恢复月经,无痛经,经量、月经周期正常.结论:应用子宫捆绑术治疗剖宫产术中出现的产后出血,不仅有效地控制出血,还可避免子宫切除,保留了生育功能,是一种有效的治疗剖宫产术中产后出血的方法,值得在临床广泛推广应用.

<正>女性盆底功能障碍(female pelvic floor dysfunction)是以压力性尿失禁,盆腔器官脱垂包括子宫脱垂、阴道前壁膨出、阴道后壁膨出以及慢性盆腔疼痛等为主要病症的一组妇科问题。现代社会中,随着人口的老龄化,盆腔器官脱垂的发病率逐步提高,并严重影响中老年妇女的生活质量,为中老年妇女的常见病,虽并非致命性疾病,但会造成令人烦恼的阴道肿物膨出、局部麻木溃疡、感染等症状,影响日常生活。盆腔脏器脱垂