宫腔镜冷刀技术在宫内疾病治疗中的应用和优势

Application and advantage of hysteroscopic cold instruments technique in treatment of intrauterine diseases

摘要:

摘要：目的 探讨宫腔镜冷刀技术在宫内疾病治疗中的应用和优势。方法 回顾性分析2016年6月－2017年8月应用法国摄普乐公司宫腔镜操作系统（HEOS）冷刀技术手术治疗宫内膜息肉、宫腔粘连、子宫纵隔、子宫黏膜下肌瘤、剖宫产瘢痕部位妊娠（CSP）及稽留流产等宫内疾病165例的临床资料。分析手术时间、术中出血量、一次性手术成功率、手术并发症和内膜保护情况（术后月经量是否少于正常）等，以判断该技术的优势。结果 宫腔镜冷刀手术治疗宫内膜息肉、宫腔粘连、子宫纵隔、子宫黏膜下肌瘤、CSP、稽留流产、妊娠物残留、宫内节育环嵌顿或残留的手术时间分别为（19.37±9.08）、（25.77±11.09）、（19.42±6.80）、（26.85±9.15）、（29.07±15.35）、（21.06±7.07）、（24.72±10.72）和（19.18±8.31）min，无术中大出血，一次手术成功164例，手术并发症2例（中度水中毒1例，子宫穿孔1例），术后经量少于正常月经量6例（非绝经患者）。结论 HEOS冷刀技术可以替代很多传统宫腔镜电切手术，HEOS宫腔镜冷刀技术不仅可以手术治疗大部分宫腔内疾病，并且具有一次性手术成功率高和对子宫内膜保护好等优势。

Abstract:

Abstract: Objective To study the application and advantage of hysteroscopic cold instruments technique in treatment of intrauterine diseases. Methods Clinical data of 165 patients managed by hysteroscopic cold instruments technique using Hysteroscopy Endo-Operative System (HEOS) respectively for endometrial polyps, intrauterine adhesions, uterine septum, submucosal uterine myoma, cesarean scar pregnancy, missed abortion and other intrauterine diseases were retrospectively analyzed. The operation time, intraoperative blood loss, success rate of the operation, surgical complications and postoperative menstrual volume changes (compared to their normal menstrual volume) were recorded and analyzed to evaluate the application and advantage of the hysteroscopic cold instruments technique in surgically managements of those intrauterine abnormalities. Results The average operation time (minutes) of endometrial polyps, intrauterine adhesions, uterine septum, submucosal uterine myomas, cesarean scar pregnancies, missed abortions, intrauterine gestational remnants and IUD removal were (19.37 ± 9.08) min, (25.77 ± 11.09) min, (19.42 ± 6.80) min, (26.85 ± 9.15) min, (29.07 ± 15.35) min, (21.06 ± 7.07) min, (24.72 ± 10.72) min, (19.18 ± 8.31) min respectively. No intraoperative massive uterine bleeding, and only one case need a second surgery. 2 patients encountered intraoperative complications (1 with moderate-degree fluid overload and the other with uterine perforation). 6 patients complained of decreased menstrual volume compared to their normal menstrual volume. Conclusion HEOS using hysteroscopic cold instruments technique can surgically treat most intrauterine diseases which might otherwise employ traditional resectoscopic technique. The high surgical success rate in one setting and less injury to the endometrium demonstrate the advantage of this technique.