宮腔鏡粘膜下肌瘤手術的并發癥2

宮腔鏡粘膜下肌瘤手術的并發癥子(zi)(zi)(zi)宮(gong)(gong)穿(chuan)(chuan)孔：電(dian)切(qie)子(zi)(zi)(zi)宮(gong)(gong)肌(ji)瘤(liu)(liu)的(de)子(zi)(zi)(zi)宮(gong)(gong)穿(chuan)(chuan)孔常發(fa)生(sheng)在于肌(ji)瘤(liu)(liu)毗鄰的(de)正常肌(ji)壁(bi)處，因子(zi)(zi)(zi)宮(gong)(gong)肌(ji)瘤(liu)(liu)的(de)發(fa)展和(he)牽拉，使該處肌(ji)壁(bi)伸(shen)展變薄，故應(ying)特別注意，必(bi)須用被動(dong)式(shi)操(cao)作架(jia)，視野不清時(shi)絕對不要通電(dian)操(cao)作。Hallez等報道61例(li)(li)手術(shu)中(zhong)子(zi)(zi)(zi)宮(gong)(gong)穿(chuan)(chuan)孔1例(li)(li)，立(li)即發(fa)現，腹(fu)腔鏡修補。Brook報道1例(li)(li)取出切(qie)割的(de)肌(ji)瘤(liu)(liu)碎(sui)片時(shi)穿(chuan)(chuan)孔，以上均未延長住院日。Loffer報道1例(li)(li)于取出宮(gong)(gong)內肌(ji)瘤(liu)(liu)組織碎(sui)片時(shi)穿(chuan)(chuan)孔。Wamsteker所做108例(li)(li)TCRM術(shu)中(zhong)發(fa)生(sheng)1例(li)(li)子(zi)(zi)(zi)宮(gong)(gong)穿(chuan)(chuan)孔，及時(shi)發(fa)現治愈。林保良所行TCRM術(shu)1156例(li)(li)中(zhong)發(fa)生(sheng)子(zi)(zi)(zi)宮(gong)(gong)穿(chuan)(chuan)孔1例(li)(li)，該例(li)(li)為(wei)卵圓鉗(qian)鉗(qian)狹(xia)肌(ji)瘤(liu)(liu)時(shi)，誤(wu)和(he)撕裂了子(zi)(zi)(zi)宮(gong)(gong)底部肌(ji)肉，導致子(zi)(zi)(zi)宮(gong)(gong)穿(chuan)(chuan)孔。