一次性阴道内镜在日间手术中的临床应用  

Clinical application of disposable vaginal endoscopy in daytime operation

作　　者：李素芬 胡秘 黎应琴 许迪 谢荣凯 LI Su-fen;HU Mi;LI Ying-qin;XU Di;XIE Rong-kai(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Army Military Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第二附属医院妇产科,重庆400038

出　　处：《生物医学工程与临床》2024年第6期836-841,共6页Biomedical Engineering and Clinical Medicine

基　　金：重庆市沙坪坝区技术创新与应用发展项目(202371)。

摘　　要：目的探讨一次性阴道内镜在日间手术中的应用价值。方法选择陆军军医大学第二附属医院进行宫腔镜日间手术患者100例,年龄27~43岁,平均年龄35.97岁(标准差7.69岁);身体质量指数(BMI)19.6~26.8 kg/m^(2),平均BMI23.05 kg/m^(2)(标准差4.85 kg/m^(2));阴道分娩56例,剖宫产44例;宫腔操作史68例;疾病类型异常子宫出血20例,宫腔粘连20例,子宫内膜息肉20例,黏膜下子宫肌瘤20例,节育器取出20例。采用随机数字表法分为两组,每组50例。对照组患者采用常规复用宫腔镜手术,试验组患者采用一次性阴道内镜手术。统计两组患者手术时间、术中出血量、扩宫率,评估患者术后1 h疼痛情况及并发症情况,并统计患者满意度评分和出院1周阴道出血量。结果试验组患者术中出血量多占比4.00%(2/50),出血量一般占比8.00%(4/50),出血少占比88.00%(44/50),对照组患者分别为20.00%(10/50)、26.00%(13/50)、54.00%(27/50);两组差异有统计学意义(P<0.05)。试验组手术时间为(12.77±5.41)min,低于对照组[(38.38±7.62)min],两组差异有统计学意义(P<0.05)。试验组扩宫率为12.00%(6/50),对照组扩宫率为64.00%(32/50);前者明显更低,差异有统计学意义(P<0.05)。试验组术后1 h视觉模拟量表(VAS)评分为(1.12±0.45)分,对照组为(2.36±1.04)分;试验组明显低于对照组,差异有统计学意义(P<0.05)。两组患者均无宫颈裂伤、大出血发生,对照组子宫穿孔2例(4.00%),试验组无子宫穿孔发生,差异无统计学意义(P>0.05)。对照组出现恶心呕吐12例(24.00%),血压/心率异常11例(22.00%),试验组分别为4例(8.00%)、3例(6.00%);两组差异有统计学意义(P<0.05)。出院1周出血量试验组少量占比56.00%(28/50),中等占比36.00%(18/50),大量占比8.00%(4/50),对照组分别为30.00%(15/50)、54.00%(27/50)、16.00%(8/50),差异有统计学意义(P<0.05)。试验组患者满意度为94.00%(47/50),对照组为70.00%(35/50),差异有统计学意义(P<0.05)。Objective To explore the application value of disposable vaginal endoscopy in daytime operation.Methods A total of 100 patients underwent hysteroscopic day operation were enrolled,which aged 27-43 years old with mean age of 35.97 years old(standard deviation 7.69 years old);body mass index(BMI)was 19.6-26.8 kg/m2 with mean BMI of 23.05 kg/m2(standard deviation 4.85 kg/m2).There were 56 cases of vaginal delivery,44 of cesarean section and 68 of uterine cavity operation history;20 cases of abnormal uterine bleeding,20 of intrauterine adhesions,20 of endometrial polyps,20 of submucosal uterine fibroids and 20 of intrauterine device removal.All patients were divided into control group(n=50,conventional hysteroscopic operation)and experimental group(n=50,disposable vaginal endoscopic operation)by random number table method.The operative time,intraoperative bleeding volume and dilatation rate of 2 groups were counted.The pain and complications at 1-hour after operation were evaluated,the patient satisfaction score and vaginal bleeding volume 1-week post discharge were counted.Results In experimental group,the excessive intraoperative bleeding volume[accounted for 4.00%(2/50)],moderate intraoperative bleeding volume[8.00%(4/50)],and restrained intraoperative bleeding volume[88.00%(44/50)]were statistically significantly lower than those of control group[20.00%(10/50),26.00%(13/50),and 54.00%(27/50)](P<0.05),respectively.The operative time of experimental group[(12.77±5.41)minutes]was statistically significantly less than that of control group[(38.38±7.62)minutes](P<0.05).The dilatation rate of experimental group[12.00%(6/50)]was significantly lower than that of control group[64.00%(32/50)],and the difference was statistically significant(P<0.05).The visual analogue scale(VAS)score at 1-hour after operation in experimental group[(1.12±0.45)scores]was statistically significantly lower than that in control group[(2.36±1.04)scores](P<0.05).There were no cervical laceration and massive hemorrhage in 2 groups,and 2 cases(

关 键 词：一次性阴道内镜技术 日间手术 临床研究 

分 类 号：R713[医药卫生—妇产科学]