宫腔镜在宫内妊娠物残留诊治中的应用

Hysteroscopy in the Diagnosis and Treatment of Intrauterine Pregnancy Residues

目的探讨宫腔镜在宫内妊娠物残留的诊断与治疗中的价值。方法2005年8月～2008年8月对66例(宫腔镜组)宫腔镜检查明确诊断宫内妊娠物残留后,38例宫腔镜下定位后行清宫术、18例宫腔镜下直视清宫术、10例宫腔镜下电切术,并与同期的68例妊娠残留物(对照组)采用传统的清宫方法比较。比较2组治愈率、手术时间、术后出血时间、出血量等。结果宫腔镜组治愈率100%(66/66)明显高于对照组75.0%(51/68)(χ2=18.897,P=0.000);宫腔镜组术后出血时间(4.1±0.8)d明显少于对照组(15.3±3.6)d(t=-24.688,P=0.000);宫腔镜组出血量(16.2±4.8)ml明显少于对照组(92.1±9.6)ml(t=-57.616,P=0.000)。宫腔镜组手术时间(43.2±6.5)min与对照组(41.8±5.9)min相比无明显差异(t=1.306,P=0.194)。结论宫腔镜是诊断及治疗宫内妊娠物残留的一种有效方法。

Objective To investigate the feasibility and effectiveness of hysteroscopy for the diagnosis and treatment of intrauterine pregnancy residues.Methods Among the patients admitted to the Futian People＇s Hospital of Shenzhen from August 2005 to August 2008,totally 66 cases with pregnancy residues were chosen as a treatment group.In all the patients,the diagnosis was confirmed by hysteroscopy.Of the patients,38 patients received curettage under hysteroscopic positioning,18 underwent curettage under direct vision,and 10 patients received hysteroscopic electrosurgical excision.In the same period,68 hospitalized patients with pregnancy residues that were treated by using traditional methods for curettage were set as a control group.The healing percentage,operation time,postoperative bleeding time,and blood loss were compared between the two groups.Results The hysteroscopy group showed significantly higher cure rate,less postoperative bleeding time,and less blood loss than the control group [100%（66/66）vs.75.0%（51/68）,χ^2=18.897,P= 0.000;（4.1±0.8）d vs.（15.3±3.6）d,t=-24.688,P=0.000;and（16.2±4.8）ml vs.（92.1±9.6）ml,t=-57.616,P=0.000].No significant difference was observed in the operation time between the two groups [（43.2±6.5）min and（41.8±5.9）min,t=1.306,P=0.194].Conclusions Hysteroscopy is an effective method in the diagnosis and treatment of intrauterine pregnancy residues.