摘要
目的探讨宫腔镜手术中子宫内膜细胞腹腔播散的特点及其影响因素。方法收集121例行宫腹腔镜联合手术的患者宫腔镜手术前后腹腔冲洗液,进行离心与细胞固定,分别在显微镜下观察腹腔冲洗液中细胞种类的变化及子宫内膜细胞阳性率的差异,根据宫腔镜手术后腹腔冲洗液中是否存在子宫内膜细胞分为阳性组和阴性组,比较两组的宫腔镜手术时间、膨宫压力、灌流液用量和子宫内膜状态等因素对子宫内膜细胞腹腔播散的影响。结果宫腔镜手术后,腹腔冲洗液中子宫内膜细胞阳性者62例(51.2%,62//21),术前腹腔冲洗液子宫内膜细胞阳性者46例(38.0%,46/121),两者比较,差异有统计学意义(P=0.020);阳性组平均手术时间为(38±16)min,阴性组为(27±13)min,两组比较,差异有统计学意义(P=0.003);两组患者术中灌流液用量、膨宫压力、子宫内膜状态等比较,差异均无统计学意义(P>0.05)。结论宫腔镜手术能够造成子宫内膜细胞的腹腔播散;在设定膨宫压力下,子宫内膜细胞的腹腔播散与宫腔镜手术时间有关。
Objective To study prospectively the hkelihood and the affecting factors of endometrial cell dissemination into the peritoneal cavity during hysteroscopic procedures. Methods A total of 121 patients with benign endometrial pathology underwent hysteroscopy combined with laparoscopy. All the patients had pelvic washings performed just before and after the procedure of hysteroscopy. We collected the peritoneal washings and analyzed the peritoneal cytology changes in both groups pre- and post-hysteroscopy , as well as the dissemination rate related to the time of hysteroscopy, the intrauterine distention pressure, the volume of distention media, and the feature of endometrial conditions. Results The ratio of positive endometrial cells in the peritoneal washings of post-hysteroscopy group was 51.2% （62/121）, which was significantly higher than pre-hysteroscopy group, 38. 0% （46/121） （P 〈0. 01 ）. The mean operation time in the group of positive peritoneal cytology was （ 38 ± 16 ） rain, longer than the negative group （ P 〈 0. 05 ）. However, there was no significant difference between the two groups with regard to the total volume of distention media, the distention pressure, and the endometrial feature （P 〉 0. 05 ） . Conclusions Hysteroscopic procedures may have a risk of disseminating the endometrial cells into peritoneal cavity. Under a certain uterine distention pressure, the rate of dissemination is correlated with hysteroscopic duration.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2007年第2期99-101,共3页
Chinese Journal of Obstetrics and Gynecology
