微创医学

目的探究超声引导下宫腔镜手术治疗子宫黏膜下肌瘤的临床疗效和安全性。方法选取100例子宫黏膜下肌瘤患者为研究对象，依据随机数字表法将其分为观察组和对照组，各50例。其中观察组患者接受超声引导下宫腔镜手术治疗，对照组患者接受常规宫腔镜手术治疗。比较两组患者的手术时间、术中出血量、术后首次下床活动时间、住院时间、子宫动脉血流动力学指标、炎症指标及术后并发症发生情况。结果两组患者的手术时间，术前子宫动脉舒张末期最小血流速度、收缩末期最大血流速度、搏动指数及白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和C反应蛋白（CRP）水平差异均无统计学意义（均P>0.05）。观察组患者的术中出血量、住院时间均少/短于对照组，术后首次下床活动时间早于对照组（均P<0.05）。术后，两组患者的IL-6、TNF-α和CRP水平均高于术前，且观察组IL-6、TNF-α和CRP水平、子宫的搏动指数、并发症的发生率均低于对照组，子宫动脉舒张末期最小血流速度、收缩末期最大血流速度均高于对照组（均P<0.05）。结论超声引导下宫腔镜手术治疗子宫黏膜下肌瘤具有手术疗效佳、风险低等特点，有助于患者快速恢复，值得临床进一步推广应用。

Objective To investigate the clinical efficacy and safety of ultrasound-guided hysteroscopy in the treatment of uterine submucous myoma. Methods A total of 100 patients with uterine submucous myoma were selected as research objects, and were divided into an observation group and a control group according to the random number table method, with 50 cases in each group. Patients in the observation group were treated with ultrasound-guided hysteroscopy, while patients in the control group were treated with conventional hysteroscopy. The operation time, intraoperative blood loss, postoperative first ambulation time, hospitalization time, uterine artery hemodynamics index, inflammation index and occurrence of postoperative complications were compared between the two groups. Results There were no statistically significant differences between the two groups in operation time, preoperative minimum end-diastolic blood flow velocity and maximum end-systolic blood flow velocity, pulsation index, and levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) (all P>0.05). The intraoperative blood loss and hospitalization time of the observation group were less/shorter than those of the control group, while the postoperative first ambulation time was earlier than that of the control group (all P<0.05). After operation, the levels of IL-6, TNF-α and CRP in the two groups were higher than those before operation, and the levels of IL-6, TNF-α and CRP, uterine pulsation index and incidence of complications in the observation group were lower than those in the control group, while the minimum end-diastolic blood flow velocity and maximum end-systolic blood flow velocity of uterine artery were higher than those in the control group (all P<0.05). Conclusion Ultrasound-guided hysteroscopy in the treatment of uterine submucous myoma has the characteristics of good surgical efficacy and low risk, which is helpful for the rapid recovery of patients, and is worthy of further clinical application.

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