肺部超声评估宫腔镜下子宫黏膜肌瘤电切手术期间液体吸收量价值探讨

Evaluation of Fluid Absorption during Hysteroscopic Myomectomy with Pulmonary Ultrasound

目的:探讨肺部超声评估宫腔镜下子宫黏膜肌瘤电切手术期间液体吸收量的应用价值。方法:回顾性收集2017年6月-2019年5月与笔者所在医院行经宫腔镜下子宫黏膜肌瘤电切手术治疗的50例患者的临床资料,根据其手术过程中膨宫液出入量差值分为>1000 ml组(n=25)与≤1000 ml组(n=25)。统计两组术后膨宫液出入量及B线数测量结果,比较两组膨宫液出入量差值、术后与术前B线数目综合评分差值,并分析两者相关性,评估术后与术前B线数目综合评分差值对过度水化综合征的预测价值。结果:>1000 ml组膨宫液出入量差值、术后与术前B线数目综合评分差值均高于≤1000 ml组,差异均有统计学意义(P<0.05);经双变量Pearson相关性检验分析证实,术后与术前B线数目综合评分差值与膨宫液出入量差值呈正相关(r=0.953,P<0.05);通过绘制ROC曲线得知,术后与术前B线数目综合评分差值预测过度水化综合征发生的AUC为0.925[95%CI(0.856,0.994)],最佳阈值为18.74分时,可获得最佳预测价值。结论:肺部超声可有效评估宫腔镜下子宫黏膜肌瘤电切手术期间液体吸收量,预测过度水化综合征发生。

Objective:To evaluate the value of pulmonary ultrasound in evaluating fluid uptake during hysteroscopic hysterectomy of uterine mucous myoma.Method:The clinical data of 50 cases of hysteromyoma treated by hysteroscopic myomectomy in our hospital from June 2017 to May 2019 were collected retrospectively.According to the difference of the amount of fluid in and out of the operation,the patients were divided into two groups:>1000 ml group(n=25)and≤1000 ml group(n=25).The postoperative expansion fluid inflow and outflow,results of B-line number measurement of the two groups were counted,the difference of postoperative expansion fluid inflow and outflow,the difference of the comprehensive score of B-line number after and before operation of the two groups were compared,the correlation between them were analyzed,the predictive value of the difference of the comprehensive score of B-line number after and before operation for hyperhydration syndrome was evaluated.Result:The difference of postoperative expansion fluid inflow and outflow,and the difference of the comprehensive score of B-line number in the>1000 ml group were higher than those in the≤1000 ml group,the differences were statistically significant(P<0.05).The analysis of bivariate Pearson correlation test confirmed that the difference in the comprehensive score of the number of B-line after and before surgery was positively correlated with the difference in the amount of dilatation fluid(r=0.953,P<0.05).According to the ROC curve,the AUC of hyperhydration syndrome predicted by the difference in the comprehensive score of the number of B-line after and before surgery was 0.925[95%CI(0.856,0.994)].When the best threshold was 18.74 points,the best predictive value could be obtained.Conclusion:Pulmonary ultrasound can effectively evaluate the fluid absorption during hysteroscopic myomectomy and predict the occurrence of hyperhydration syndrome.