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目的 比较传统宫腔镜与双重宫腔镜手术系统(HEOS系统)宫腔镜治疗难治性宫内妊娠组织残留的临床效果.方法 选择温州市中西医结合医院2017年1月至2019年2月收治的难治性宫内妊娠组织残留患者60例为研究对象,根据接受手术的不同将其分为传统腔镜组与HEOS系统腔镜组,每组30例.比较两组手术时间、术中出血量、住院费用、术后子宫粘连率、术后月经恢复时间,术后1个月、2个月、3个月子宫内膜恢复良好率.结果 传统腔镜组手术时间[(24.38±3.16)min]长于HEOS系统宫腔镜组[(18.71±3.32)min](t=1.336,P=0.027),其术中出血量[(18.41±4.35)mL]多于HEOS系统宫腔镜组[(12.81±3.84)mL](t=1.853,P=0.031),住院费用[(7461.87±344.92)元]多于HEOS系统宫腔镜组[(6743.19±298.52元)](t=0.037,P=0.040).传统宫腔镜组术后子宫粘连率[20.00％(6/30)]明显高于HEOS系统宫腔镜组[6.67％(2/30)](χ2=2.308,P=0.029),其术后月经恢复时间[(31.46±4.12)d]长于HEOS系统宫腔镜组[(26.18±3.72)d](t=1.730,P=0.026),传统腔镜组术后1个月、2个月、3个月子宫内膜恢复良好率依次为20.00％(6/30)、43.33％(13/30)、63.33％(19/30),HEOS系统腔镜组依次为46.67％(14/30)、70.00％(21/30)、93.33％(28/30),HEOS系统宫腔镜组术后1、2、3个月子宫内膜恢复良好率优于传统宫腔镜组(χ2=4.800,P=0.028;χ2=4.344,P=0.037;χ2=7.954,P=0.005).结论 HEOS系统宫腔镜治疗难治性宫内妊娠组织残留效果明显优于传统宫腔镜,值得临床推广.“,”Objective To compare the clinical effects of conventional hysteroscopy and HEOS hysteroscopy in the treatment of refractory intrauterine residuals.Methods From January 2017 to February 2019,60 patients with refractory intrauterine pregnancy residuals admitted to the Integrated Traditional Chinese and Western MedicineHospital of Wenzhou were randomly selected .The patients were divided into traditional endoscopy group and HEOS system endoscope group according to the different operation method ,with 30 cases in each group.The operation time, intraoperative blood loss , hospitalization cost , postoperative uterine adhesion rate , postoperative menstrual recovery time,postoperative recovery rate of endometrium at the first ,second and third month after operation were compared between the two groups.Results The operation time of the conventional laparoscopic group was (24.38 ±3.16)min, which was longer than that of the HEOS system hysteroscopy group [(18.71 ±3.32)min](t=1.336,P=0.027). The intraoperative blood loss of the conventional laparoscopic group was (18.41 ±4.35) mL,which was higher than that of the HEOS system hysteroscopy group[(12.81 ±3.84)mL](t=1.853,P=0.031).The hospitalization cost of the conventional laparoscopic group was (7461.87 ±344.92) CNY,which was more than that of the HEOS system hysteroscopy group[(6743.19 ±298.52)CNY](t=0.037,P=0.040).In addition,the uterine adhesion rate in the traditional hysteroscopic group was 20.00％( 6/30 ) , which was higher than that in the HEOS system hysteroscopy group[6.67％(2/30)] (χ2 =2.308,P=0.029),and the postoperative menstrual recovery time in the traditional hysteroscopic group was ( 31.46 ±4.12 ) d, which was longer than that in the HEOS system hysteroscopy group [(26.18 ±3.72)d](t=1.730,P=0.026).At the first,second and third month after operation ,the good endometrial recovery rates in the traditional laparoscopic group were 20.00％(6/30),43.33％(13/30),63.33％(19/30), respectively,which were lower than those in the HEOS system hysteroscopy group [46.67％(14/30),70.00％(21/30),93.33％(28/30)](χ2 =4.800,4.344,7.954,P =0.028,0.037,0.005).Conclusion HEOS system endoscope in the treatment of refractory intrauterine residual has good effect and is worthy of promoting .