阴道内镜技术在无性生活史女性宫腔疾病诊治中的临床应用  

Clinical application of vaginoscopy technology in the diagnosis and treatment of uterine cavity diseases in women with asexual life history

作　　者：苏婷婷[1] 张宏伟[2] 汪清[2] 谢锋[2] 丛青[2] 李燕云[2] 隋龙[2,3] 陈丽梅 SU Ting-ting;ZHANG Hong-wei;WANG Qing;XIE Feng;CONG Qing;LI Yan-yun;SUI Long;CHEN Li-mei(Department of Cervical Diseases,Obstetrics and Gynecology Hospital,Fudan University,Yangtze River Delta Integration Demonstration Zone(Qingpu),Shanghai 201713,China;Hysteroscopy Center,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200011,China;Shangbai Key Laboratory of Female Reproductive Endocrine-Related Diseases,Shanghai 200011,China)

机构地区：[1]复旦大学附属妇产科医院长三角一体化示范区青浦分院宫颈科,上海201713 [2]复旦大学附属妇产科医院宫腔镜中心,上海200011 [3]上海市女性生殖内分泌相关疾病重点实验室,上海200011

出　　处：《复旦学报（医学版）》2024年第5期772-777,共6页Fudan University Journal of Medical Sciences

基　　金：上海市科委科研计划项目(16411950200);上海市自然科学基金面上项目(22ZR1408800)。

摘　　要：目的探讨阴道内镜技术对无性生活史女性宫腔疾病诊治的临床应用价值。方法回顾性分析2020年1月至2023年12月在复旦大学附属妇产科医院行阴道内镜检查和传统宫腔镜检查的无性生活史女性患者450例,包括阴道内镜组(n=232)和传统宫腔镜组(n=218)。两组患者的平均年龄分别为(24.9±4.7)岁和(25.5±5.4)岁,两组年龄间无明显差异(P>0.05)。分析比较两组的手术时长、术中出血量、膨宫液用量、术中出现假道、手术失败情况、并发症发生率、术后疼痛评分等情况。结果阴道内镜组中手术平均时间比传统宫腔镜组短,膨宫液用量更少,VAS疼痛评分更低,但手术失败情况比例明显高于传统宫腔镜组(7.8%vs.0),上述指标在两组间的差异均有统计学意义(P<0.05)。并发症方面,阴道内镜组出现假道概率更少(0 vs.3.2%),处女膜损伤率更低(0 vs.85.3%),差异均有统计学意义(P<0.05)。两组术中出血量差异无统计学意义,术后感染发生率相当,均较低。两组患者均未发生术中子宫穿孔、空气栓塞等并发症。结论阴道内镜技术对无性生活史女性宫腔疾病的诊治安全有效,较传统宫腔镜更微创,不损伤处女膜,值得临床推广。Objective To explore the clinical value of vaginoscopy in the diagnosis and treatment of uterine cavity diseases in virgins.Methods We retrospectively reviewed the data of 450 patients who underwent vaginoscopy and traditional hysteroscopy in Obstetrics and Gynecology Hospital,Fudan University from Jan 2020 to Dec 2023,including vaginoscopy group(n=232)and traditional hysteroscopy group(n=218).The average ages of the two groups were 24.9±4.7 years and 25.5±5.4 years,and there was no significant difference between the two groups(P>0.05).The operation time,estimated blood loss,fluid deficit,false passage,surgical failure,incidence of complications and postoperative pain score were compared between vaginoscopy group and traditional hysteroscopy group.Results Compared with the traditional hysteroscopy group,the average operation time in the vaginoscopy group was shorter,the fluid deficit was less,and the VAS pain score was lower,but the rate of surgical failure was higher(7.8%vs.0),all the differences were statistically significant(P<0.05).In terms of complications,the incidence of false passage in the vaginoscopy group was less(0 vs.3.2%)and the rate of hymen injury was lower(0 vs.85.3%),the differences were statistically significant(P<0.05).There was no significant difference in the estimated blood loss between the two groups,and the incidence of postoperative infection was similar in both groups.There were no complications such as uterine perforation and air embolism in both groups.Conclusion Vaginoscopy is safe and effective,more minimally invasive than traditional hysteroscopy,does not damage the hymen,and is suitable for virgins.This technology is worthy of clinical application.

关 键 词：阴道内镜 非接触式宫腔镜检查 无性生活史 宫腔疾病 

分 类 号：R711.74[医药卫生—妇产科学]