宫内节育器取出术中应用子宫内膜细胞采集器筛查子宫内膜病变的价值

Value of Endometrial Sampling Device for Cytology in Endometrial Lesion Screening during Removal Surgery of Intrauterine Contraceptive Device

目的探讨宫内节育器(IUD)取出术中使用子宫内膜细胞采集器采集子宫内膜组织,进行子宫内膜病变筛查的临床应用价值。方法选取2014年4月—2015年10月于徐州市妇幼保健院进行IUD取出术的患者128例为研究对象。采用随机数字表法将患者分为试验组(62例)和对照组(66例)。两组按常规方法取出IUD,试验组取出IUD后用子宫内膜细胞采集器采集子宫内膜组织。记录两组术中出血量、手术时间、人工流产综合反应的发生情况及术后阴道流血持续时间。结果患者均完整取出IUD,两组患者术中出血量、手术时间、人工流产综合反应发生率及术后阴道流血持续时间比较,差异均无统计学意义(P>0.05)。试验组因症取出IUD患者异常子宫内膜检出率为27.8%(10/36),高于无症状取出IUD患者的7.7%(2/26)(P=0.048)。结论在IUD取出术中应用子宫内膜细胞采集器采集子宫内膜组织行病理检查不增加术中及术后出血、手术时间及人工流产综合反应发生率,且因症取出IUD患者异常子宫内膜检出率高于无症状取出IUD患者。

Objective To study the clinical application value of the endometrial sampling device for endometrial biopsy in endometrial lesion screening during removal surgery of intrauterine contraceptive device（ IUD）.Methods From April 2014 to October 2015,128 patients undergoing removal surgery of IUD in Xuzhou Maternity and Child Health Care Hospital were selected and divided into the experiment group（ 62 patients） and control group（ 66 patients） by random number table method.IUD in both groups were removed by conventional methods.And endometrial biopsy was conducted with the endometrial sampling device for cytology after removing IUD in the experiment group.The amount of bleeding,time of operation,occurrence of artificial abortion syndromes,and the duration of vaginal bleeding after operation of all the patients were recorded.Results All patients had completely removed IUD,there was no significant difference in the amount of bleeding,time of operation,occurrence of artificial abortion syndromes,and the duration of vaginal bleeding after operation between two groups（ P〈0.05）.In the experiment group,the relevance ratio of abnormal endometrium of patients removing IUD due to symptoms was 27.8%（ 10 /36）,which was significantly higher than that 〔7.7%（ 2 /26） 〕of asymptomatic patients（ P = 0.048）.Conclusion The application of endometrial sampling device for cytology during removal surgery of IUD to perform pathological examination of endometrial tissues will not increase intra-operative and postoperative bleeding,time of operation and occurrence of artificial abortion syndromes,and the relevance ratio of abnormal endometrium of patients removing IUD due to symptoms is higher than that of the asymptomatic patients.