超声引导在妇科介入手术诊疗中的应用研究

Application of ultrasonic guidance in diagnosis and treatment of gynecological interventional operation

目的:探讨超声引导在妇科介入手术中的应用价值及安全性。方法:回顾性分析我院2011-01~2017-08行超声引导下妇科介入手术患者4 198例,其中无痛人流术2 146例,输卵管通液术342例,卵巢囊肿抽吸固化术674例,子宫肌瘤射频自凝刀消融术247例,子宫内膜射频消融术769例,异位妊娠囊穿刺、氨甲喋呤注射治疗术20例。分析手术成功率、手术时间、术中出血量、并发症发生情况及复发率。结果:无痛人流术成功率100%,穿孔1例;输卵管通液术成功率94.15%,失败20例;卵巢囊肿抽吸固化术成功率99.23%,失败3例,复发10例;子宫肌瘤消融成功率100%,复发12例;子宫内膜消融成功率100%;异位妊娠囊穿刺、氨甲喋呤注射成功率100%。各类手术时间相对较短,并发症发生率及复发率均较低。结论:妇科介入手术在超声引导下操作直观便捷,安全性高,不良反应少,患者耐受性好,手术成功率高,并发症发生率及复发率低,值得临床推广应用。

Objective：To discuss the application value and safety of ultrasonic guidance in gynecological interventional operation.Methods：A total of 4 189 patients treated with gynecological interventional operation guided with ultrasound from January 2011 to Auguest 2017.There were 2 146 cases with painless abortion,342 cases with hydrotubation,674 cases with ovarian cyst suction and curing,247 cases with radiofrequency ablation of leiomyoma by radiofrequency self coagulation knife,769 cases with radiofrequency ablation of endometrium,20 cases with methotrexate injection for ectopic pregnancy.The operation success rate,operation time,amount of bleeding,occurrence of complication and recurrence rate were analyzed.Results：The abortion success rate of painless was 100%,1 cases of perforation.The success rate of hydrotubation was 94.15%,20 cases of failed.The success rate of ovarian cyst suction curing surgery was 99.23%,3 cases of failed,10 cases were relapsed.The success rate of radiofrequency ablation of leiomyoma by radiofrequency self coagulation knife was 100%,and 12 cases were relapsed.The success rate of endometrium ablation of endometrium was 100%.The success rate of methotrexate injection for ectopic pregnancy was 100%.The above operation time was relatively short,and the occurrence of complications and recurrence rates were lower.Conclusion：Gynecologic interventional under ultrasound guidance is intuitive and convenient,with high safety,less adverse reactions,good tolerance,high operative success rate,low operative complication rate and recurrence rate.It is worthy of popularization and application.