经阴道超声引导在计划生育手术中的应用  

Application of transvaginal ultrasonography in the operations of family planning

作　　者：史文静[1] 周龙书[1] 何凤仪[1] 戚潜辉[1] 

机构地区：[1]广州医学院第二附属医院妇科,广州510260

出　　处：《广东医学》2011年第24期3181-3184,共4页Guangdong Medical Journal

基　　金：广东省医学科研基金资助项目(编号:A2010254)

摘　　要：目的探讨经阴道超声引导可视技术在无痛人流术、宫内节育器取出术、输卵管通液术中的应用价值。方法选取于经阴道超声引导可视下行计划生育手术患者179例(可视组),其中行无痛人流术98例,宫内节育器取出术42例,输卵管通液术39例;同期行普通计划生育手术患者193例(普通组),其中行无痛人流术93例,宫内节育取出术46例,输卵管通液术54例。对上述两组的手术时间、术中失血量和术中术后并发症发生率等进行比较。结果无痛人流术中,可视组的初孕者、非初孕者的绝对手术时间(min)分别为2.9±1.4、2.2±1.1,普通组分别为4.1±2.5、3.3±2.1;可视组和普通组的术中、术后失血量(mL)分别为15.6±6.3、25.9±10.4,22.1±7.7、33.7±12.8;可视组的绝对手术时间,术中、术后失血量明显少于普通组(P<0.05);可视组无一例出现术后并发症,普通组1例子宫穿孔,3例吸宫不全,无漏吸。输卵管通液术中可视组33例,32例与最后腹腔镜检查结果相一致,而普通组39例,输卵管通液术提示的输卵管通畅的13例中经腹腔镜检查3例为输卵管积水,2例为盆腔粘连,阴性诊断符合率为61.5%。宫内节育器取出术中,可视组的绝对手术时间[(2.3±1.2)min]少于普通组[(3.4±1.9)min],差异有统计学意义(P<0.05)。两组术中失血量、总手术时间差异无统计学意义(P>0.05)。结论经阴道超声引导可视技术可减少无痛人流手术的绝对手术时间、失血量、术后并发症发生率,可减少宫内节育器取出术的绝对手术时间,可提高输卵管通液术中对输卵管通畅度的客观评价,避免了常规输卵管通液术的盲目性。Objective To investigate the application of transvaginal ultrasonography in induced abortion, hydrotubation, and intrauterine device. Methods A total of 179 patients with family planning operations with transvaginal ultrasonography, including 98 cases of induced abortion, 42 cases of intrauterine device removal and 39 cases of hydrotubation, were randomly enrolled in Uhrasonography Group （Group U）, while 193 patients with family planning operations without transvaginal uhrasonography, including 93 cases of induced abortion, 46 cases of intrauterine device and 54 cases of hydrotubation, were enrolled as controls （ Group C）. The operation time, blood loss and operation complication between the two groups were compared. Results In induced abortion, no significant difference in total operation time was found between the two groups （P 〉 0. 05 ）. However, there were significant reduction in net operation time, blood loss and operation complication were revealed in induced abortion in Group U （ P 〈 0. 05 ）. In hydrotubation, almost same diagnostic rate （32/33） was found in Group U, comparing with that with laparoscopy. However, the negative diagnostic accordance rate was 61.5% in Group C. In intrauterine device removal, significantly shorter net operation time was found in Group U （P 〈 0. 05 ）, whereas there no significant difference in operation blood loss or total operation time was revealed between the two groups （P 〉 0. 05）. Conclusion The application of transvaginal uhrasonography in family planning operations can shorten the net operation time, decline the blood loss and reduce the operation complication in induced abortion. It can also improve the objective evaluation of fallopian tube patency and shorten operation time in the removal of intrauterine device.

关 键 词：经阴道超声 人流术 输卵管通液术 宫内节育器取出术 

分 类 号：R714.221[医药卫生—妇产科学]