论文部分内容阅读
目的观察分析超声引导下清宫术、宫腔镜下病灶搔刮电切术及药物杀胚联合宫腔镜下病灶搔刮电切术3种不同方法对持续宫腔胚胎残留的治疗效果。方法对2010年10月-2015年1月间,因不全流产经一次盲探性清宫术后,仍有异常阴道流血而来院就治的117例宫腔胚胎组织残留患者,分组采用超声引导下行清宫术治疗39例(A组),宫腔镜下残留胚胎组织病灶搔刮电切术治疗41例(B组),药物杀胚联合宫腔镜下残留胚胎组织病灶搔刮电切术治疗37例(C组),并对3组间患者的手术成功率、手术时间、手术中出血量、治疗有效率及术后宫腔感染率等进行统计比较。结果手术成功率、临床治愈率B组、C组均分别明显高于A组(χ~2=9.784 7,P<0.01;χ2=6.327 8,P<0.01);手术时间B组明显短于A组和C组(t=8.960 9,P<0.01和t=7.611 9,P<0.01);术中出血量B组也明显少于A组和C组(t=14.808 4,P<0.01和t=13.043 0,P<0.01)。结论3种方法均可有效治疗持续宫腔胚胎组织残留,但根据胚胎残留部位及性质,在宫腔镜下用电切环搔刮电切术及药物杀胚联合宫腔镜下用电切环搔刮电切术在清除反复清宫术后仍存在宫腔残留胚胎组织的病例中,能达到准确诊断定位,微创省时,无并发症,疗效好,可在临床中推广应用。
Objective To observe and analyze the therapeutic effects of three different methods of uterine curettage, hysteroscopic lesions scraping resection and drug killing embryo combined with hysteroscopic lesions scraping resection on the continuous uterine embryo residue treatment. Methods From October 2010 to January 2015, 117 cases of residual uterine embryo tissue with abnormal vaginal bleeding were still found after incomplete blindness due to incomplete vaginal abortion. The patients were divided into two groups by ultrasonic guided descending 39 cases were treated by surgery (group A), 41 cases were treated by hysteroscopic residual embryo tissue scraping and resection (group B), 37 cases were treated by drug killing embryo combined with hysteroscopic residual embryo tissue lesion (Group C). The success rates of operation, operation time, blood loss during operation, effective rate of treatment and postoperative intrauterine infection were compared between the three groups. Results The success rate of surgery and clinical cure rate in group B and group C were significantly higher than those in group A (χ ~ 2 = 9.784 7, P <0.01; χ2 = 6.327 8, P <0.01) (T = 8.9609, P <0.01 and t = 7.6119, P <0.01). The blood loss in group B was also significantly less than those in groups A and C (t = 14.808 4, P <0.01 and t = 13.043 0, P <0.01). Conclusion All the three methods are effective in treating persistent uterine embryonic tissue residues. However, according to the residual parts and properties of embryos, the electrosurgical excision and cystoscopic electrosurgical excision Scratch resection in the removal of recurrent curettage residual uterine tissue remains in the cases, to achieve accurate diagnosis and positioning, minimally invasive, no complications, good effect, can be widely used in clinical practice.