超导可视技术在基层医院妇科临床中的应用  

Application of ultrasound-guided visualization in gynecological clinic in primary hospitals

作　　者：孙宜梅 SUN Yi-mei(Department of Gynecology,Dianshan Lake People's Hospital,Kunshan 215345,China)

机构地区：[1]昆山市淀山湖人民医院妇科,215345

出　　处：《中国实用医药》2023年第12期98-101,共4页China Practical Medicine

摘　　要：目的 探讨超导可视技术在基层医院妇科临床手术中应用范围,增加手术的准确性,减少并发症的发生。方法 160例妇科患者,随机分为观察组和对照组,每组80例。观察组患者在超导可视技术指导下进行手术,对照组患者在常规盲视下进行手术。根据病理检查结果确定患者最后诊断,并比较两组患者手术时间、术中出血量、手术成功率。结果 160例患者中,送病理检查72例,病理检查结果提示:子宫内膜单纯性增生期改变15例,不典型增生1例。送检组织中见子宫内膜息肉样改变12例。2例术前诊断为子宫内膜息肉,观察组及对照组各1例。送检组织中见绒毛、退变绒毛组织、蜕膜样组织共42例,其中观察组和对照组均为21例,观察组清宫患者术后1周复查超声无异常,血人绒毛膜促性腺激素(HCG)水平明显下降,手术成功率为100%(21/21);对照组不完全流产清宫手术患者术后1周行阴道超声检查,发现宫腔不均质稍高回声2例(考虑宫腔内胚胎组织残留),示为失败,1例改为超导可视下清宫,1例予黄体酮及桂枝茯苓胶囊口服12 d,月经来潮后复查,2例超声均无异常发现,血HCG≤5 mIU/ml。观察组节育环嵌顿及高危患者取环及人工流产手术成功率均高达100%(44/44)。对照组21例高危妊娠流产,1周后复查有2例患者宫腔超声有异常回声,示为失败;考虑不完全流产可能,血HCG较流产前1 d水平下降<70%,予超导可视下清宫及病理检查确诊为人工流产后组织残留。对照组节育环嵌顿12例,其中1例取环过程中节育环断裂,部分残留,示为失败,改为超导可视指导下手术。对照组因高危因素取环11例患者中,有1例宫颈扩张困难,示为失败,为防止子宫穿孔及其他并发症发生,改为静脉麻醉超导引导下手术。观察组患者手术时间(5.0±2.0)min短于对照组的(10.5±2.5)min,术中出血量(10.0±4.5)ml少于对照组的(30.5±10.5)ml,手术成功率98.8%Objective To discuss the application scope of ultrasound-guided visualization in gynecological clinical surgery in primary hospitals to increase the accuracy of surgeries and reduce the occurrence of complications.Methods A total of 160 gynecological patients were randomly divided into the observation group and the control group.The observation groups used ultrasound-guided visualization to guide the surgery,and the control group performed the surgery in the case of routine blindsight.The final diagnosis of the patients was determined according to the pathological examination results,and the operating time,intraoperative blood loss and surgical success rate were compared between the two groups.Results Of the 160 patients,72 cases were sent for pathological examination,and the pathological findings suggested that there were 15 cases of simple hyperplastic endometrial changes and 1 case of atypical hyperplasia;endometrial polyp-like changes were seen in 12 cases.2 cases were preoperatively diagnosed as endometrial polyps,1 case each in the observation group and control group.A total of 42 cases of villi,degenerated villi and deciduloid tissues were found in the tissues examined,including 21 cases in both the observation group and the control group.The patients in the observation group showed no abnormality in ultrasound examination one week after surgery,and the blood human chorionic gonadotrophin(HCG)level decreased significantly,and the surgical success rate was 100%(21/21).In the control group,2 cases of incomplete miscarriage with slightly high echogenicity in the uterine cavity were found on vaginal ultrasound 1 week after surgery(considering the residual embryonic tissue in the uterine cavity),which were indicated as failure.Among them,1 case was changed to ultrasound-guided curettage,and 1 case was given progesterone and Guizhi Fuling capsule orally for 12 d.Reexamination after menstruation showed no abnormal ultrasonic findings in 2 cases,and blood HCG≤5 mIU/ml.The surgical success rate of the patients wi

关 键 词：超导可视技术 子宫内膜息肉 节育环嵌顿 高危妊娠 不完全流产 子宫内膜增生 

分 类 号：R713[医药卫生—妇产科学]