妇科无痛人工流产手术中阴道超声引导的应用体会

Experience of painless induced abortion under the guidance of transvaginal ultrasound in Department of Gynecology

目的分析妇科无痛人工流产手术中阴道超声引导的应用效果及安全性.方法60例自愿要求实施无痛人工流产患者,随机分为对照组和实验组,每组30例.对照组应用常规盲视下无痛人工流产手术,实验组手术中全程应用阴道超声引导下无痛人工流产手术.观察比较两组手术时间、术中出血量、术后阴道出血时间以及并发症发生情况.结果实验组手术时间(4.65±1.63)min、术后阴道出血时间(3.12±0.65)d均明显短于对照组的(10.41±2.09)min、(7.43±1.98)d,术中出血量(20.65±3.24)ml少于对照组的(35.41±4.51)ml,差异具有统计学意义(P<0.05).实验组吸宫不全、术后阴道出血时间延长、漏吸、月经量减少、宫颈管或宫腔粘连发生率分别为3.3%、6.7%、0、6.7%、0,均明显低于对照组的20.0%、26.7%、16.7%、46.7%、13.3%,差异具有统计学意义(P<0.05).两组均未发生子宫穿孔.结论相比常规盲视下无痛人工流产手术,应用超声引导下无痛人工流产手术的效果更为显著,有效地缩短了手术时间,减少了术中出血量和术后并发症的发生,值得临床推广.

Objective To analyze the effect and safety of painless induced abortion under the guidance of transvaginal ultrasound in Department of Gynecology. Methods A total of 60 patients volunteered for painless induced abortion were randomly divided into control group and experimental group, with 30 cases in each group. The control group was treated with painless induced abortion under conventional blindness, while the experimental group was treated with painless induced abortion under the guidance of transvaginal ultrasound. The control group was treated with painless induced abortion under conventional blind vision, while the experimental group was treated with painless induced abortion under the guidance of transvaginal ultrasound. Observation and comparison were made on operation time, amount of intraoperative hemorrhage, postoperative vaginal bleeding time and occurrence of complications between the two groups. Results The experimental group had obviously shorter operation time as (4.65 ± 1.63) min, postoperative vaginal bleeding time as (3.12 ± 0.65) d than (10.41 ± 2.09) min and (7.43 ± 1.98) d in the control group, and less amount of intraoperative hemorrhage as (20.65 ± 3.24) ml than (35.41 ± 4.51) ml in the control group. Their difference was statistically significant (P<0.05). The experimental group had incidence of incomplete uterine aspiration, prolonged vaginal bleeding, missed aspiration, decreased menstrual volume, cervical canal or intrauterine adhesions respectively as 3.3%, 6.7%, 0, 6.7% and 0, which were obviously lower than 20.0%, 26.7%, 16.7%, 46.7% and 13.3% in the control group, and their difference was statistically significant (P<0.05). No uterine perforation occurred in both groups. Conclusion Compared with painless induced abortion under conventional blindness, painless induced abortion under the guidance of transvaginal ultrasound shows more significant effect. It can effectively shorten the operation time, reduce intraoperative hemorrhage and postoperative complications. It is worthy of clinical promotion.