阴道内镜的临床应用评价

Evaluation of clinical application of vaginoscopy

目的对幼女或未婚女性及普通患者采取阴道内镜(vaginoscopy)的宫腔镜非接触性技术对此类患者检查施治,查找出血原因取出阴道内异物,并分析评价治疗方法。方法以140例患者为研究对象,对幼女(15例)或未婚女性(20例)及其他55例普通患者采用阴道内镜技术对其进行阴道及宫腔检查并取出阴道内异物,用注射器经检查镜侧孔抽吸子宫内膜病理标本,通过特殊的比量法测量宫腔深度,对其他50例普通患者采用常规宫腔镜检查方法进行检查,记录所有患者的手术时间,术后疼痛状况。术后对所有患者进行随访,了解感染情况。结果幼女或未婚女性患者在检查中均未损伤处女膜。阴道内镜检查与常规宫腔镜检查相比手术时间差异无显著性,术后疼痛明显低于常规宫腔镜检查(P<0.05)。所有患者均无术后盆腔感染情况发生。92.73%的阴道内镜检查患者病理取材满意。结论阴道内镜检查可以显著地减低宫腔镜检查时的疼痛,免除了对处女膜的损伤。可取出阴道内异物,发现由阴道内而非宫腔内引发出血的疾患所在。镜体位置移动更加灵活,便于对子宫位置极度偏曲的患者进行检查。采用经检查镜侧孔进行活检取材,在绝大多数的情况下病理取材满意。较常规宫腔镜检查更微创,尤其适合幼女及未婚患者的下生殖道病变的检查,具有推广应用价值。

[Objective] To analyze and evaluate the vaginoscopy,which is a trans-vaginal no-touch technique to the little girls,virgin and ordinary patients,and to investigate the vaginal bleeding and remove the vaginal foreign body.[Methods] A total of 140 patients were recruited,of which including 15 cases of children,20 cases of virgin and 55 ordinary patients in investigational group,and 50 common patients in control group.Vaginoscopic examination of vaginal and uterine was given to children,virgin and 55 ordinary patients remove the vaginal foreign body.Endometrial specimens for pathologic use were suctioned by syringe through side hole of hysteroscopy,and uterine cavity depth was measured to investigational group using special method.Conventional method of hysteroscopy was given to the control group.Operation time and post-operational pain were recorded.All the patients in investigational group and control group will be followed-up for infection condition.[Results] The hymen was not damaged during the investigation of vaginoscopy for little girls and virgin.There was no significant difference for operation duration time and condition of post-operation infection between vaginoscopy group and hysteroscopy group,however,there was significant difference（P 0.05） for post-operation pain between two groups.No patients in two groups experienced pelvic infection.It was satisfactory to 92.73% of endometrial specimens by vaginoscopy.The accurate measurement of uterine cavity depth was gained for all the patients.[Conclusions] Vaginoscopy can significantly reduce the pain experienced by patients during the procedure and eliminate damage to the hymen.Vaginoscopy not only can remove the vaginal foreign body,identifying the bleeding disorder caused by vaginal but not uterine,and thus expanding the scope of inspection,but also has more flexibility of moving endoscopy＇s position so as to examine the patient with extreme deviated uterine from normal position.Post operation pelvic infection and vaginal infection has not increased and hysteroscopy duration time has not extended.The pathologically satisfaction in most cases when deriving biopsy via side hole of hysteroscopy.Precise measurement of depth of uterine cavity can be gained by vaginoscopy.Vaginoscopy is much more mini-invasive compared to general hysteroscopy,it specially fits for little girls,as well as virgin to examine lower genital tract lesions.It is valued to be promoted.