日间病房宫腔镜手术前宫颈管扩张方法研究  

Study on the method of dilatation of uterine cervix before hysteroscopic surgery in day ward

作　　者：刘颖蔚[1] 邓幼林[1] 曹毅[1] LIU Yingwei;DENG Youlin;CAO Yi(Department of Gynecology,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院妇科,重庆400016

出　　处：《中国性科学》2021年第1期99-101,共3页Chinese Journal of Human Sexuality

基　　金：重庆市中青年医学高端人才培养项目

摘　　要：目的探讨不同宫颈管扩张方法对宫腔镜手术的影响,以期缩短宫腔镜术前准备时间、减少并发症、缩短住院时间、达到日间病房的管理要求。方法选取2016年9月至2017年7月重庆医科大学附属第一医院妇科日间病房拟行宫腔镜手术的165例患者作为研究对象。根据随机数字表法分为利多卡因组(n=55)、药物组(n=55)和尿管组(n=55)。比较三组围术期生命体征、宫颈扩张效果、疼痛评分、围术期并发症等指标。结果三组扩宫法实施前、扩宫法实施后、术前即刻、术后4h血压比较,差异无统计学意义(P>0.05)。药物组、尿管组的扩宫棒号数显著高于利多卡因组,差异具有统计学意义(P<0.05),而药物组和尿管组比较,差异无统计学意义(P>0.05)。药物组、尿管组四个时间点的视觉模拟评分法(VAS)评分均显著低于利多卡因组,差异具有统计学意义(P<0.05),药物组和尿管组比较,差异无统计学意义(P>0.05)。药物组和尿管组严重并发症发生率低于利多卡因组,差异具有统计学意义(P<0.05)。结论药物扩张法及尿管扩张法可提升宫颈扩张效果、改善围术期疼痛、降低围术期并发症,日间病房宫腔镜手术时建议优先选用。Objective To explore the influence of different methods of cervical dilation on hysteroscopic surgery,in order to shorten the preparation time before hysteroscopy,reduce complications,shorten the length of hospital stay,and meet the management requirements of day ward.Methods 165 patients who planned to undergo hysteroscopic surgery in the gynecological day ward of the First Affiliated Hospital of Chongqing Medical University from September 2016 to July 2017 were selected as the research subjects.According to random number table method,they were divided into lidocaine group(n=55),drug group(n=55)and urinary catheter group(n=55).Perioperative vital signs,cervical dilation effect,pain score,perioperative complications and other indicators were compared between the three groups.Results There was no significant difference in blood pressure between the three groups before,after,immediately before and 4h after the operation of uterine dilation(P>0.05).The number of dilating rod in the drug group and the urinary catheter group was significantly higher than that in the lidocaine group(P<0.05),but there was no significant difference between the drug group and the urinary catheter group(P>0.05).The VAS scores of the drug group and the urinary catheter group at four time points were significantly lower than those of the lidocaine group,with statistical significance(P<0.05),while there was no statistical significance between the drug group and the urinary catheter group(P>0.05).The incidence of serious complications in the drug group and urinary catheter group was lower than that in the lidocaine group,and the difference was statistically significant(P<0.05).Conclusions Drug dilatation and catheter dilatation can improve the effect of cervical dilatation,relieve perioperative pain,and reduce perioperative complications,which are recommended to choose first in hysteroscopic surgery in day ward.

关 键 词：宫腔镜 扩宫法 日间病房 

分 类 号：R711[医药卫生—妇产科学]