可视人流仪术中监测对瘢痕子宫取环妇女应激状态的影响  

Eeffects of visual abortion monitor on stress during removing intrauterine device from scarred uterus patients

作　　者：王昊珏[1,2] 方杰[1] 陆显义 王蕾[2] 张秋莹[2] WANG Hao-jue;FANG Jie;LU Xian-yi;WANG Lei;ZHANG Qiou-yin(School of medicine,Jiangsu university,Jiangsu Zhenjiang 212013,China;Department of Obstetrics and gynecology,Xishanpeople,Hospital of Wuxi City(The Zhongda Hospital Affiliated to Southeast University Wuxibranch),Jiangsu Wuxi214011,China)

机构地区：[1]江苏大学医学院,江苏镇江212013 [2]无锡市锡山人民医院/东南大学附属中大医院无锡分院妇产科,江苏无锡214011

出　　处：《东南大学学报（医学版）》2017年第2期261-265,共5页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:研究可视人流仪术中监测对瘢痕子宫妇女取环术中的应激激素的影响及临床疗效。方法:按随机数字表法将拟行取环术再生育的瘢痕子宫妇女分为A、B两组,A组实验组采用可视人流仪监护下取环,B组对照组采用常规方法取环,比较两组取环手术的手术时间、术中出血量、术中疼痛程度、手术顺利情况、应激激素变化、术后第一次月经来潮时间及月经变化、术后妊娠等情况。结果:A组与B组相比,术中疼痛程度轻、一次性手术取环成功率高(98.95%vs 90%)、子宫穿孔发生例数少(0 vs 5例),术后阴道流血时间短(6.5±12.03 vs 10.34±10.34天),术后第一次月经来潮快(25.12±0.56 vs 30.45±1.87天),宫颈管粘连的发生病例数少(2 vs 8例)。B组术前和术中、术后的应激激素血液表达水平均高于A组,且两组术中血液表达水平均高于术前及术后,差异均具有统计学意义(P<0.05)。术后三月妊娠率高(11.45%vs 3.0%)差异有统计学意义(P<0.05).而术后一年妊娠率(36.45%vs 33%),差异无统计学意义(P>0.05)。结论:可视人流仪对瘢痕子宫取环术中监护对患者应激状态影响小,要好于常规方法,安全性更高。O bjecti'^e;To study the effect of visual artificial abortion monitor on stress hormones effect of operation during the removal of intrauterine device from scarred uterus.M etliods;Patients uterus scheduled for reproduction after removal of intrauterine device were randomly divided into witli the random number table.The experiment group was subjected to extraction of intrauterine device underthe monitoring of visual artificial abortion monitor while the control group was operated by conventionalThe operation tim e#the am ount o f b le e d in g#adverse e ffe c t#the in tra op erative p a in d e gre e#success the le v e l o f stress horm ones o f two groups before the e x a m in a tio n,d u rin g the exam ination and after tlie e x a postoperative vag in al b le e d in g,firs t postoperative m enstruation and c y c le,and pregnancy after operation were detectedand com pared.R esults:G roup A com pared w itli group B,a s ig n ific a n t decrease was observed in the operationtim e!from4.2±0.30to2.2±0.66m in),the am ount o f in tra op erative ble e d in g(from?4±1.4to2.8士1.6m l),and in in tra op erative p a in degree,success rate o f surgery was h ig h e r,the le v e l o f stress horm ones andp a in stress indexes o f group B before the o p e ra tio n,d u rin g the operation and after h ig h e r than those o f group A,and the levels o f two groups d u rin g the operation those before the operation and a fte r the o p e ra tio n;firs t postoperative m enstruation was s h o rte r!fro m25.12±0.56to30.45±1.87d a ys),and o c u ra n c e o f the ce rv ix o f the uterus tube adhesion was lo w er(fro m2to@cases)$thepregnancy rate o f tiire e m onth after operation was h ig h e r(from11.45%to3.0%)(P<0.05).A s ig n ific a n t in creasewas not observed in the pregnancy rate o f one year a fte r operation(from36.4%to33%)(!>0?05).C onclusion:The visu a l abortion m o n ito r has little effect on stress state o f patients w itii scarred uterus than e n tio n a l m e t!io d,a n d has h ig h e r safety.

关 键 词：瘢痕子宫 可视人流仪 节育环 应激激素 

分 类 号：R714[医药卫生—妇产科学]