黄桂清

【摘要】 目的：探討和比较宫腔镜下可视清宫术和超声引导下清宫术在妊娠物残留患者中的治疗效果。方法：选取2015年3月-2016年2月笔者所在医院因人工流产术或早孕药物流产后行妊娠物残留取出术治疗的患者115例，根据治疗方法将其分为观察组（60例）和对照组（55例）。观察组采用宫腔镜下可视清宫术，对照组采用超声引导下清宫术，比较两组患者宫颈口扩张情况和镇痛效果、临床指标（手术时间、苏醒时间、术中出血量）情况、术后并发症发生率。结果：两组宫颈口扩张程度和镇痛效果比较，差异无统计学意义（P>0.05）；两组患者临床指标术中出血量和苏醒时间比较，差异无统计学意义（P>0.05），但手术时间比较，观察组明显长于对照组，差异有统计学意义（P<0.05）；观察组术后并发症发生率明显低于对照组，差异有统计学意义（P<0.05）。结论：妊娠物残留患者采用宫腔镜下可视清宫术，虽然手术时间比超声引导下清宫术长，但其能有效降低术后并发症的发生率，具有重要的价值，值得在临床妊娠物残留取出术中应用。

【关键词】 妊娠物残留； 宫腔镜下可视清宫术； 超声引导下清宫术； 并发症

doi：10.14033/j.cnki.cfmr.2017.18.004 文献标识码 A 文章编号 1674-6805（2017）18-0008-03

Contrast of the Effect of Hysteroscopic Visualization and Ultrasound Guided Curettage in Patients with Pregnancy Residues/HUANG Gui-qing.//Chinese and Foreign Medical Research，2017，15（18）：8-10

【Abstract】 Objective：To discuss and contrast the effect of hysteroscopic visualization and ultrasound guided curettage in patients with pregnancy residues.Method：Selected 115 patients who were treated with pregnancy residues removed surgery after artificial abortion or drug abortion，from March 2015 to February 2016 in our hospital.The patients were divided into the observation group（60 cases） and the control group（55 cases），according to the different treatments.The observation group was treated with hysteroscopic visualization curettage for visual，and the control group was treated with ultrasound guided curettage，compared the cervical dilatation and analgesia effect，clinical indicators（operation time，recovery time，amount of bleeding），the incidence of postoperative complications between the two groups.Result：Compared the cervical dilation degree and the analgesic effect，there were no significant differences between the two groups （P>0.05）；compared the clinical indicators of the amount of intraoperative bleeding and the recovery time，the differences were not statistically significant（P>0.05），but the operation time of the observation group was significantly longer than that of the control group，the difference was statistically significant（P<0.05）；the incidence of postoperative complications were significantly lower than the control group，the difference was statistically significant（P<0.05）.Conclusion：Although the time of surgery is longer than ultrasound guided curettage，the patients with pregnancy residues using hysteroscopic visualization curettage can decrease postoperative complications effectively，which has important value，worthy of clinical application in patients with pregnancy residues .endprint

【Key words】 Pregnancy residues； Hysteroscopic visualization curettage； Ultrasound guided curettage； Complication

First-authors address： Guigang Maternal and Child Health-Care Hospital，Guigang 537100，China

妊娠物残留是人工流产术或药物流产后较为常见的并发症，目前传统妊娠物残留取出术，最常用的处理方法为负压吸引刮宫术又称清宫术，该方法容易出现的问题是盲目刮宫从而引起或导致子宫腔粘连，更严重情况是有可能影响再次妊娠。而在妊娠物残留取出术中使用超声引导下清宫术可能会出现妊娠物残留取不干净或再次发生等情况，对刮宫造成的严重影响尚不明确[1]。宫腔镜下可视清宫术是指能明确找到残留物位置，其刮宫术目的性比较强，能快速取出妊娠残留物，大大减少了因过度刮宫所导致的不良并发症的发生[2]。本研究为……