不全流产行宫腔镜下清宫术与传统清宫术的临床效果对比研究

A Comparative Study on the Clinical Effect of Hysteroscopic Uterine Evacuation and Traditional Uterine Evacuation in Incomplete Abortion

目的探讨对不全流产采用宫腔镜辅助下清宫手术治疗与传统清宫术治疗临床效果。方法选择2018年1月—2020年12月曲阜市妇幼保健计划生育服务中心诊治不全流产患者200例,根据手术方式不同分为门诊手术常规清宫术治疗的对照组与采用宫腔镜辅助下清宫术治疗的观察组,各100例。比较两组手术成功率以及手术相关指标(手术时间、出血量、出血持续时间),评估患者月经恢复情况以及术后子宫内膜厚度,并统计两组治疗后并发症发生率。结果观察组手术成功率高于对照组(99.00%vs 91.00%),差异有统计学意义(χ^(2)=6.737,P<0.05)。观察组手术时间为(15.45±2.69)min,与对照组对比,差异无统计学意义(t=1.905,P>0.05);观察组出血量、出血持续时间分别为(25.48±8.47)mL、(5.77±1.03)d分别小于、短于对照组,差异有统计学意义(t=8.688、3.605,P<0.05)。观察组月经恢复时间(28.93±4.09)d短于对照组,术后子宫内膜厚度(11.76±1.37)mm大于对照组,差异有统计学意义(t=6.293、12.444,P<0.05)。观察组并发症总发生率较对照组更低(4.00%vs 18.00%),差异有统计学意义(χ^(2)=10.010,P<0.05)。结论对不全流产者予宫腔镜辅助下清宫术治疗疗效可靠,能够减少出血量以及子宫内膜损伤,有利于患者术后康复,且可降低并发症风险。

Objective To investigate the clinical effect of hysteroscopy-assisted uterine evacuation and traditional uterine evacuation in the treatment of incomplete abortion.Methods From January 2018 to December 2020,200 patients with incomplete abortion diagnosed and treated in Qufu Maternal and Child Health Care and Family Planning Service Center were selected.According to the operation method,they were divided into the control group(outpatient surgery)with conventional uterine curettage and the observation group(hysteroscopy-assisted uterine curettage),with 100 cases in each group.The operation success rate and operation-related indicators(operation time,blood loss,bleeding duration)were compared between the two groups.The menstrual recovery and postoperative endometrial thickness of the patients were assessed.The incidence of complications after treatment in the two groups was also analyzed.Results The success rate of operation in the observation group was higher than that in the control group(99.00%vs 91.00%),and the difference was statistically significant(χ^(2)=6.737,P<0.05).The operation time of the observation group was(15.45±2.69)min,and there was no statistically significant difference compared with the control group(t=1.905,P>0.05).The amount of blood loss and duration of bleeding in the observation group were(25.48±8.47)mL and(5.77±1.03)d,respectively,which were less than and shorter than those in the control group,and the differences were statistically significant(t=8.688,3.605,P<0.05).The menstrual recovery time of the observation group was(28.93±4.09)d shorter than that of the control group,and the postoperative endometrial thickness of the observation group was(11.76±1.37)mm longer than that of the control group,and the differences were statistically significant(t=6.293,12.444,P<0.05).The total incidence of complications in the observation group was lower than that in the traditional curettage group(4.00%vs18.00%),and the difference was statistically significant(χ^(2)=10.010,P<0.05).Con⁃clusion Hysteroscopy-assisted uterine evacuation is a reliable treatment for patients with incomplete abortion,which can reduce the amount of bleeding and endometrial damage,which is beneficial to the postoperative recovery of patients,and can reduce the risk of complications.