高危宫腔因素下宫腔操作技术的观察

Observation of uterine operation technology on the condition of high risk uterine factors

目的:探讨高危宫腔因素下宫腔手术(人工流产、上环)的安全性。方法:选择高危宫腔因素的对象进行人流手术和上环手术。人流手术组200例,随机又分为观察组:行可视人流术100例,对照组:行传统人流术100例;上环手术组126例,在超声监测下的上环手术41例为观察组,传统上环85例为对照组。高危因素包括:哺乳期、剖宫产、子宫肌瘤剔除史、多次人流史、子宫极度屈曲、宫颈管迂曲狭窄等。对两组术中及术后情况分别进行对比分析。结果:①人流手术观察组术中人工流产综合征发生率低于对照组(P<0.05),两组术后阴道流血量、月经恢复情况差异有统计学意义(P<0.05),阴道流血时间观察组为(6.50±1.88)天,对照组为(7.44±2.57)天,两组差异有统计学意义(t=2.949,P=0.004)。②上环手术观察组术后阴道流血量、阴道流血时间及腰腹坠痛症状均少于对照组(P<0.05)。结论:高危宫腔因素下宫腔手术在超声监视下进行,能降低人流综合征发生和减少术后流血时间,能减少上环手术近期并发症的发生,提高高危宫腔因素下宫腔手术的安全性。

Objective：To explore the safety of uterine surgeries（artificial abortion,placement of IUD） on the condition of high risk uterine factors.Methods：The study objects with high risk uterine factors received artificial abortion and placement of IUD.200 cases in artificial abortion group were divided into observation group and control group randomly： 100 cases in observation group were treated with visual artificial abortion and 100 cases in control group were treated with routine artificial abortion.126 cases in IUD group were divided into observation group and control group randomly： 41 cases in observation group were treated with placement of IUD under the monitoring of ultrasound and 85 cases in control group were treated with routine placement of IUD.The high risk factors included lactation,cesarean section,myomectomy,history of artificial abortion for many times,extreme uterine flexion,circuity and stenosis of cervical canal.The intraoperative and postoperative conditions in the two groups were compared and analyzed.Results：In artificial abortion group,the incidence of induced abortion syndrome in observation group was lower than that in control group（P0.05）,there was significant difference in the amount of vaginal bleeding after operation and recovery of menstruation between the two groups（P0.05）,the duration times of vaginal bleeding in observation group and control group were（6.50±1.883） days and（7.44±2.571） days,respectively,there was significant difference between the two groups（t=2.949,P=0.004）.In IUD group,the amount of vaginal bleeding after operation,duration time of vaginal bleeding and the incidences of lumbar and abdominal bearing-down pain in observation group were lower than those in control group（P0.05）.Conclusion：Uterine surgery under the monitoring of ultrasound on the condition of high risk uterine factors can reduce the incidence of induced abortion syndrome,duration time of vaginal bleeding after operation,the occurrence of short-term complications during the course of placement of IUD,increase the safety of uterine surgery on the condition of high risk uterine factors.