CAJ | 학술논문

目的：研究宫颈环形套扎配合米索前列醇片在宫腔镜手术中的应用。方法：我院2011年5月至2014年12月间收治准备行宫腔镜手术的病例161例，每一病种按入院顺序分别分入A、B、C 3组。 A组54例术前4 h米索前列醇400μg塞阴道，术中乳胶套圈环形套扎宫颈；B组54例术前4 h米索前列醇400μg塞阴道；C组53例为对照组。对比3组的宫颈扩张情况、手术时间、宫颈损伤情况。结果：A、B组首次能直接通过≥7号扩张棒的分别有38、41例，分别占70．37％、75．93％，与C组（6例、11．32％）比差异有统计学意义， P＜0．05。 A、B 两组组间比较差异无统计学意义，P ＞0．05。 A、B、C 组平均手术时间分别为（29．54±6．23）、（40．87±7．65）、（67．49±5．27）min，A、B两组分别与C组相比，差异有统计学意义，P＜0．05。 A组宫颈损伤率18．52％（10／54）、B组宫颈损伤率37．04％（20／54）、C组宫颈损伤率92．45％（49／54），3组组间比较，差异有统计学意义，P＜0．05。结论：米索前列醇用于宫腔镜手术前软化宫颈口准备效果肯定，若加用宫颈环形套扎使宫颈管闭合性更好，术中漏水发生率有所下降、膨宫效果更理想。此法操作简单，值得临床推广应用。
목적：연구궁경배형투찰배합미색전렬순편재궁강경수술중적응용。방법：아원2011년5월지2014년12월간수치준비행궁강경수술적병례161례，매일병충안입원순서분별분입A、B、C 3조。 A조54례술전4 h미색전렬순400μg새음도，술중유효투권배형투찰궁경；B조54례술전4 h미색전렬순400μg새음도；C조53례위대조조。대비3조적궁경확장정황、수술시간、궁경손상정황。결과：A、B조수차능직접통과≥7호확장봉적분별유38、41례，분별점70．37％、75．93％，여C조（6례、11．32％）비차이유통계학의의， P＜0．05。 A、B 량조조간비교차이무통계학의의，P ＞0．05。 A、B、C 조평균수술시간분별위（29．54±6．23）、（40．87±7．65）、（67．49±5．27）min，A、B량조분별여C조상비，차이유통계학의의，P＜0．05。 A조궁경손상솔18．52％（10／54）、B조궁경손상솔37．04％（20／54）、C조궁경손상솔92．45％（49／54），3조조간비교，차이유통계학의의，P＜0．05。결론：미색전렬순용우궁강경수술전연화궁경구준비효과긍정，약가용궁경배형투찰사궁경관폐합성경호，술중루수발생솔유소하강、팽궁효과경이상。차법조작간단，치득림상추엄응용。
Objective: To study the cervical loop ligation with the application of misoprostol tablets in hysteroscope operation.Methods: 161 women ready for hysteroscopy in our hospital in May 2011 to December 2014, every disease in hospital order was divided into group A, B, C respectively.Group A:54 cases, 4 hours before surgery, plugging 400 μg in vagina; and ligaturing the uterine cervix with rubber ferrule.Group B:54 cases, 4 hours before surgery, plugging 400 μg in vagina; Group C: 34 cases, for the control group.The cervical dilatation, operation time, and cervical injury of three groups were compared.Results: 38, 41 cases, respectively in group A and B, for the first time, can be directly through the 7 expansion rod, accounting for 70.37%, 75.93%;And compared with patients in group C (6 cases, 11.32%) there were significant differences, <br> P<0.05.But there was no significant difference between the group A and B, P>0.05.The average operation time was(29.54 ±6.23) min in group A,(40.87 ±7.65) min in group B,(67.49 ±5.27) min in group C, compared with group C, group A and B respectively had significant difference, P<0.05.Cervical injury rate was 18.52%(10/54) in group A, 37.04%(20/54) in group B, 92.45%(49/54) in group C, there were significant differences among three groups, P<0.05.Conclusion: The effect of misoprostol in cervical preparation before hysteroscopic operation is positive; This method is simple in operation, it is worthy of clinical application.If combining with cervical loop ligation, closure properties of cervical canal can be better.Intraoperative leakage rates decline.Besides, the effect for expanding uterine cavity is satisfying.