改进TCRA术中能量器械使用方法提高手术疗效的临床体会  

Clinical experience of improving the use of energy instruments in TCRA to improve the surgical efficacy

作　　者：陈丽刚[1,2] 时灿灿[1] 孙翠[2] 王乾兴[1] Chen Ligang Shi Cancan Sun Cui Wang Qianxing(Department of Cell Biology and Genetics, Zunyi Medical University, Zunyi Guizhou 563099, China Depart- ment of Gynecology, Affiliate Hospital of Maternal and Child Health Care of Zunyi Medical University, Zunyi Guizhou 563000, China)

机构地区：[1]遵义医学院细胞生物学与遗传学教研室,贵州遵义563099 [2]遵义医学院附属遵义市妇女儿童医院妇科,贵州遵义563000

出　　处：《遵义医学院学报》2017年第4期417-421,共5页Journal of Zunyi Medical University

摘　　要：目的探讨在宫腔镜下宫腔粘连分离术中减少能量器械产生的副损伤及手术并发症的方法。方法选择我院2015年1至12月确诊为中、重度宫腔粘连的患者112例,分为对照组和观察组,分别实施TCRA手术和改进的TCRA手术,比较两组患者手术并发症,手术时间,术中出血量及术后疗效的差异。结果观察组和对照组分别有0和5例出现副损伤或并发症,两组手术平均时间和术中出血量分别为(25.6±5.8)min、(10.2±5.6)mL和(35.5±8.5)min、(25.1±5.2)mL,差异具有统计学意义(P<0.05);观察组的临床疗效88.89%明显高于对照组72.41%,差异具有统计学意义(P<0.05)。结论改进的TCRA手术方式及技巧可以明显降低宫腔粘连手术副损伤或并发症,提高临床疗效。Objective To investigate the methods to reduce energy devices-caused side injuries and complications in transcervical resection of adhesion（ TCRA）. Methods From January to December 2015,a total of 112 patients with confirmed moderate and severe intrauterine adhesions in our hospital were selected. The patients were divided into control group and observation group,which were treated with TCRA and modified TCRA respectively. Surgical complications,duration of surgery,intraoperative blood loss and postoperative efficacy in the two groups were compared. Results There was no side injury and surgical complication in the observation group while there were 5 patients in the control group had side injuries and surgical complications. The average duration of surgery and intraoperative blood loss in the observation group and the control group were（ 25. 6 ± 5. 8） min,（ 10. 2 ± 5. 6） ml,（ 35. 5 ± 8. 5） min,and（ 25. 1 ± 5. 2） ml,respectively,presenting statistically significant differences（ P〈0. 05）. Clinical efficacy in the observation group（ 88. 89%） was obviously higher than that in the control group（ 72. 41%）,with a statistically significant difference（ P〈0. 05）. Conclusion The modified TCRA can significantly reduce surgical side injuries or complications and increase clinical efficacy.

关 键 词：宫腔粘连 宫腔镜能量器械 手术副损伤 疗效 

分 类 号：R713.4[医药卫生—妇产科学]