摘要
目的:初步探讨新型宫腔镜刨削(IBS)系统治疗育龄女性子宫内膜息肉和黏膜下肌瘤的临床效果和安全性。方法:采用回顾性分析方法,将接受IBS系统治疗子宫内膜息肉和黏膜下肌瘤48例为研究组(IBS组),同期接受普通双极宫腔镜电切系统治疗者42例为对照组(普通电切组),分别比较两组不同患者手术情况(手术时间、灌注介质总量、灌注介质吸入量),手术前后相关生化指标(Hb、血钾、血钠、血糖)的变化,以及术后2个月随访子宫内膜修复情况。结果:①IBS组黏膜下肌瘤患者手术时间明显短于普通电切组黏膜下肌瘤患者(P<0.001),IBS组子宫内膜息肉和黏膜下肌瘤患者的灌注介质总量和灌注介质吸入量均比普通电切组明显减少(P<0.05,P<0.001)。②两组术前、术后生化指标比较,差异均无统计学意义(P>0.05)。③在术后随访中,IBS组黏膜下肌瘤患者的阴道流血或流液的时间显著短于普通电切组黏膜下肌瘤患者(P<0.05)。IBS组宫腔黏膜下肌瘤患者比普通电切组宫腔黏膜下肌瘤患者的子宫内膜厚度厚(P<0.05)。有1例普通电切组黏膜下肌瘤患者术后发生了宫腔粘连。结论:新型IBS系统与普通双极电切系统相比,虽然在内膜息肉切除过程中优势不明显,但是对于黏膜下肌瘤切除术,具有手术时间短、灌注介质用量少,并发症少的特点,对于育龄期女性具有保护子宫内膜的优势,是一种安全有效的无创手术。
Objective: To investigate the clinical efficacy and safety of a new hysteroscopic shaving system for the treatment of uterine endometrial polyps and submucousmyoma of childbearing age women.Methods: All pa- tients with uterine disease ( endometrial polyps or submucousmyoma) were retrospectively divided into two groups,48 patients undergone the new hysteroscopic shaving system were set as study group named IBS group, another 42 patients undergone the electrosection were set as control group named general hysteroscopic electro- surgery group.Then the surgical condition( the operation time,the total amount of perfusion medium and the vol- ume of perfusion medium intake),the changes of biochemical indicators during the surgery( Hb,blood potassium, sodium and glucose) and the postoperative of endometrial repair were compared.Results:①The operation time of submucousmyoma in IBS group was significantly shorter than that of general hysteroscopic electrosection group ( P<0. 001).The total amount of perfusion medium and the amount of perfusion medium( P<0. 05) intake of pa- tient with endometrial polyps or submucousmyoma in IBS group were both lower than those in general hystero- scopic electrosection group( P<0. 001).②The biochemical parameters( for example,Hb,K+,Na+,Glu) of the two groups had no significant difference before and after surgery( P>0. 05).③During the postoperative follow-up,the time of vaginal bleeding( or discharge) of the submucousmyoma in IBS group was significantly shorter than that in the general resection group( P<0. 05);and the postoperative endometrial thickness of patient with submucousmy- oma in IBS group was thicker than that in the general resection group( P<0. 05).However,there was a case of submucousmyoma in the general resection group occurred intrauterine adhesions after the surgery.Conclusions: Compared with the common bipolar electrosurgical system,the new IBS system has no obvious advantage in the process of endometrial polypectomy.But the new IBS system for the treatment of uterine submucousmyoma has the advantages of the shorter operation time,smaller amount of perfusion medium,no complications of surgery and protecting the endometrium for childbearing age women,so it is a safer and much effective non-invasive surgery.
作者
施君
金悦
叶婧
李毓
王育
SHI Jun;JIN Yue;YE Jing(Department of Obstetrics and Gynecology,Renji Hospital,School of Medicine,Shanghai Jiaotong University, Shanghai 200127,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2019年第7期509-513,共5页
Journal of Practical Obstetrics and Gynecology
关键词
宫腔镜
新型宫腔镜刨削系统
宫腔疾病
子宫内膜息肉
黏膜下肌瘤
育龄期
Hysteroscopy
New hysteroscopic shaving system
Uterine endometrial polyps
Submucousmyo- ma
Childbearing age women
