阴道内镜技术在宫腔镜检查中的临床应用研究  

Clinical application of vaginoscopic hysteroscopy

作　　者：李奇迅 徐云[2] 郭蕾[2] 余秋蓉 徐兰芝[2] 杨保军[2] 赵卫红[2] 孔令蕤[1] 冯力民[2] 

机构地区：[1]北京市门头沟区医院妇产科,北京102300 [2]首都医科大学附属北京天坛医院妇产科,北京100050 [3]内蒙古锡林郭勒盟太仆寺旗医院妇产科,内蒙古026000

出　　处：《中国实用妇科与产科杂志》2017年第1期118-121,共4页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的评价阴道内镜技术应用于门诊宫腔镜检查中的可行性、优势和局限性。方法 2015年5月至10月对北京天坛医院行宫腔镜检查的患者,不使用任何麻醉和镇痛,采用阴道内镜技术进行宫腔镜检查,计算其成功率、患者的视觉模拟量表(VAS)疼痛评分、失败原因分析、失败人群构成分析(年龄、孕产次、分娩方式、绝经、痛经),以寻找阴道内镜的适合人群。结果 103例患者进行阴道内镜检查,成功率72.82%,VAS评分的中位数为2,失败的主要原因是宫腔镜不能通过宫颈内口,使用Logistic回归分析年龄、剖宫产史、绝经状态、痛经、阴道分娩史、阴道分娩次数与阴道内镜的成功率均无相关性。结论阴道内镜技术进行宫腔镜检查具有较高的成功率,减轻了患者的疼痛,适用人群广泛,可作为门诊宫腔镜检查的操作方式之一。Objective To evaluate the feasibility,advantages and limitation of the vaginoscopic approach for office hysteroscopy.Methods From May 2015 to October 2015 in Beijing Tiantan Hospital,the patients who underwent diagnostic hysteroscopy by vaginoscopic approach without any anesthesia or analgesia were evaluated with regard to the success rate,the patient’s VAS（a visual analog scale）score,the reason for failure,failure population composition（age,caesarean section,menopausal status,dysmenorrhea,vaginal delivery,parity）,and the correlation between these factors,in order to find the suitable population for vaginal endoscopy.Results Totally 103 patients underwent vaginoscopic approach,and the success rate was 72.82%.The main reason for the failure was that hysteroscope couldn’t pass through the cervical canal,median VAS score being 2.Logistic regression analysis was made on age,caesarean section,menopausal status,dysmenorrhea,and history and number of vaginal delivery,which showed that the above factors had no correlation with the success rate.Conclusion Because it is with high success rate and can reduce the pain of patients,vaginoscopic hysteroscopy is applicable for a wide range of people.Vaginoscopy can be used as one of the noninvasive methods in the outpatient hysteroscopy.

关 键 词：宫腔镜检查 阴道内镜 门诊宫腔镜 

分 类 号：R71[医药卫生—妇产科学]