微创医学

目的探讨宫腔镜在取器困难患者中的应用及其麻醉方法和取环时间的选择。方法取器困难患者行宫腔镜取环232例,分为静脉麻醉组(A组)116例及局部麻醉组(B组)116例,各组又分为两组,围绝经组(A1、B1)各64例及绝经1年以上组(A2、B2)各52例。比较不同麻醉方法在不同年龄组中的宫腔镜取器成功率。结果 A组取器成功111例,成功率95.7%,B组取器成功97例,成功率83.6%,静脉麻醉组在取器困难患者中取器成功率优于局部麻醉组(P=0.003,P<0.05);A1组取器成功64例,成功率100.0%,B1组取器成功60例,成功率93.8%,围绝经期两组取器成功率差异无统计学意义(P=0.119,P>0.05);A2组取器成功47例,成功率90.4%,B2组取器成功37例,成功率71.2%,绝经1年以上者取器成功率静脉麻醉组优于局部麻醉组(P=0.013,P<0.05)。结论宫腔镜取器明显优于传统方法,年龄及麻醉方法影响宫腔镜在取器困难患者中的取器成功率。

Objective To explore the use of hysteroscope in repeated removal of intrauterine devices,determine the way and the time of repeated removal of intrauterine devices and the way of anesthesia.Methods 232 cases were recruited to hysteroscopy,with 116 cases in intravenous anesthesia group(group A) and 116 cases in infiltration anesthesia group(group B).Group A and B were divided into two groups respectively,with 64 cases in perimenopause group(group A1,B1) and 52 cases of more than one year postmenopause in postmenopause group(group A2,B2),compared the completion rate of different anesthesias in different age.Results 111 cases were conducted in group A(95.7%,112/116) and 97 cases were conducted in group B(83.6%,97/112),the completion rate in intravenous anesthesia group was more than that in infiltration anesthesia group(P=0.003,P<0.05).64 cases were conducted in group A1(100.00%,64/64) and 60 cases were conducted in group B1(93.8%,60/64),with no statistical significance in completion rate(P=0.119,P>0.05).47 cases were conducted in group A2(90.4%,47/52) and 37 cases were conducted in group B2(71.2%,37/52),with statistical significance in completion rate(P=0.013,P<0.05).Conclusion The repeated removal of intrauterine devices with hysteroscope is better than the traditional methods.Intravenous anesthesia can be the first-line anesthesia method.