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目的:探讨高危宫腔因素下宫腔手术(人工流产、上环)的安全性。方法:选择高危宫腔因素的对象进行人流手术和上环手术。人流手术组200例,随机又分为观察组:行可视人流术100例,对照组:行传统人流术100例;上环手术组126例,在超声监测下的上环手术41例为观察组,传统上环85例为对照组。高危因素包括:哺乳期、剖宫产、子宫肌瘤剔除史、多次人流史、子宫极度屈曲、宫颈管迂曲狭窄等。对两组术中及术后情况分别进行对比分析。结果:①人流手术观察组术中人工流产综合征发生率低于对照组(P<0.05),两组术后阴道流血量、月经恢复情况差异有统计学意义(P<0.05),阴道流血时间观察组为(6.50±1.88)天,对照组为(7.44±2.57)天,两组差异有统计学意义(t=2.949,P=0.004)。②上环手术观察组术后阴道流血量、阴道流血时间及腰腹坠痛症状均少于对照组(P<0.05)。结论:高危宫腔因素下宫腔手术在超声监视下进行,能降低人流综合征发生和减少术后流血时间,能减少上环手术近期并发症的发生,提高高危宫腔因素下宫腔手术的安全性。
Objective: To investigate the safety of uterine cavity surgery (induced abortion, Sheung Wan) in high-risk uterine cavity. Methods: Select high-risk uterine factors for abortion and surgery on the ring. The abortion group was divided into observation group (n = 100), control group (n = 100), ablation group (n = 126) and observation group (n = 41) Group, the traditional ring 85 cases as control group. Risk factors include: lactation, cesarean section, history of myomectomy, multiple abortion history, extreme uterine buckling, cervical canal tortuous stenosis. The two groups were compared after surgery and postoperative conditions. Results: (1) The incidence of abortion syndrome in abortion group was lower than that in control group (P <0.05). There was significant difference in vaginal bleeding and menstruation between the two groups (P <0.05), vaginal bleeding time The observation group was (6.50 ± 1.88) days, while the control group was (7.44 ± 2.57) days. The difference between the two groups was statistically significant (t = 2.949, P = 0.004). ② The postoperative vaginal bleeding volume, vaginal bleeding time and lumbar pain symptom in Shanghuan surgical observation group were less than those in control group (P <0.05). Conclusions: High-risk uterine cavity under uterine cavity surgery under ultrasound surveillance can reduce the incidence of flow syndrome and reduce postoperative bleeding time, can reduce the incidence of recent surgical complications and improve the high-risk uterine cavity under the operation of uterine cavity safety.