[Objective] To investigate the curative effect and complication prevention of transcervical resection of myoma( TCRM) with drug therapy in the treatment of submucosal myoma of uterus. [ Methods ] A total of 75 patients with uterine submucosal myoma were treated with TCRM from October 2003 to October 2009.Their diameters were greater than 50 mm. Among them, 13 cases were type 0, 30 type I and 32 type II . All cases received the therapy of GnRH-a for three months, the myoma diameters came to be (33±12) mm. They were removed by using different surgical methods. The patients of multiple uterine myoma or adenomyosis were set IUD Mirena after operation. The operation courses, outcomes, complication prevention, residual myoma growth and repeated surgeries were reviewed. Curative effects were evaluated according to post-operative menstruation improvement and residual myoma growth. [Results] 75 submucosal myomas were totally resected, measuring 20~50 mm in diameter (33±12) mm. The operation time was (37±14) min. The intraoperalive blood loss of (48±15) mL. The residual myoma in diameter by ultrasonography monitoring did not increase and no new myoma was found, post-operative menstruation was improved after one year. [Conclusions] TCRM is the golden standard in the treatment of submucosal myoma of uterus. Preoperation GnRH-a therapy and setting Mirena posloperation can be useful and necessary to enlarge selection of patients, decrease difficulty during operation, and strict prevention of complications.%目的 评价宫腔镜电切术联合应用GnRH-a(达菲林)曼月乐治疗子宫肌瘤的疗效及并发症的预防.方法 2003年10月～2009年10月在该院检查诊断子宫黏膜下肌瘤直径＞50 mm者75例,其中O型13例,Ⅰ型30例,Ⅱ型32例.手术前应用GnRH-a(达菲林)3个月,肌瘤直径(33±12)mm,其中O型33例,Ⅰ型27例,Ⅱ型15例行宫腔镜下子宫肌瘤切除术,合并多发肌瘤及子宫腺肌症者术后放置曼月乐,分析手术时间、出血量、并发症及术后月经等情况,评价疗效.结果 切除黏膜下肌瘤75个,肌瘤直径20～ 50 mm,平均(33±12)mm.手术时间(37±14)min,出血量(48±15)mL.2例术中出血,1例术后发热.多发肌瘤和子宫腺肌症术后放置曼月乐,随访至术后1年,超声监测肌瘤无复发,月经改善明显.结论 经宫腔镜电切子宫肌瘤是治疗子宫黏膜下肌瘤的最佳选择方式,针对分型选择药物综合治疗,扩大手术适应证,减少手术难度和并发症的出现.
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