宫腔镜对复杂宫内胚物残留的诊治价值

Value of hysteroscopy in diagnosis and treatment of complex intrauterine gestational residuum

目的:探讨宫腔镜对复杂宫内胚物残留的诊治价值。方法:对162例确诊复杂宫内胚物残留病例进行回顾性分析,所有患者都接受阴式B超检查,随机抽取其中的88例进行宫腔镜检查,比较两种检查方法对复杂宫内胚物残留的准确率;所有患者随机接受宫腔镜下清宫术(宫腔镜组,87例)或超声监护下清宫术(对照组,75例),比较两组患者术中出血量、手术时间及手术成功率。结果:宫腔镜检查准确率(98.86%)高于阴式B超组(85.86%),宫腔镜手术组术中平均出血量为99.51 ml,对照组为120.40 ml,宫腔镜组平均手术时间24.40 min,对照组30.81 min,宫腔镜组手术成功率91.95%,对照组60.00%,两组各指标比较差别均有统计学意义(P<0.05)。结论:宫腔镜检查复杂宫内胚物残留准确率高,处理妊娠病灶效果好,安全性高,值得临床推广。

Objective： To investigate the diagnostic and therapeutic value of hysteroscopy for complex intrauterine gestational residuum. Methods： 162 cases of complex intrauterine gestational residuum were examined by transvaginal B - ultrasound. Among them, a randomly selected group of 88 patients were examined by hysteroscopy. The accuracy of the complex intrauterine gestational residuum examined by the two methods were analyzed comparatively. On the other hand, 87 of them selected randomly received the complete curettage of uterine cavity by hysteroscopy （the group of hysteroscopy）, and the others （75 cases） received the complete curettage of uterine cavity under B ultrasound （control group） . The average intraoperative blood loss, operation time, and the success rate of the two group were analyzed com- paratively. Results： The accuracy examined by hysteroscope was 98.86% , which was significantly higher than that in control group by b - ultrasound （85.86%） . In contrast, less average intraoperative blood loss （99. 51 ml vs 120. 40 ml）, shorter operation time （24. 40 rain vs 30. 81 min）, higher success rate （91.95% vs 60.00% ） significant differences were observed in the group of hysteroscope （P 〈0. 05） Conclusion ： The situations of complex intrauterine gestational residuum can be diagnosed more accurately by hysteroscopy. The treatment of pregnancy disease by hysteroseopy indicates high efficiency and safety, it is worth popularizing.