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中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2020, Vol. 13 ›› Issue (01): 36 -40. doi: 10.3877/cma.j.issn.1674-6899.2020.01.009

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阴道内镜技术在门诊宫腔镜检查中的应用价值
彭燕蓁 1, 段华 1 , †( ), 成九梅 1, 闫硕 1, 苏琦 1   
  1. 1. 100006 北京，首都医科大学附属北京妇产医院妇科微创中心
  • 收稿日期:2019-12-16 出版日期:2020-02-28
  • 通信作者: 段华
  • 基金资助:
    首都医科大学临床医学高精尖学科建设项目(1192070309); 北京市医管局临床医学发展专项"杨帆计划""(ZYLX201406); 首都卫生发展科研专项重点攻关资助项目(首发2014-1-2112)

Study on the vaginoscopic approach to outpatient hysteroscopy

Yanzhen Peng 1, Hua Duan 1 , †( ), Jiumei Cheng 1, Shuo Yan 1, Qi Su 1   

  1. 1. Center of Minimally Iinvasive Gynecological Surgery of Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University, Beijing 100006, China
  • Received:2019-12-16 Published:2020-02-28
  • Corresponding author: Hua Duan
  • About author:
    Corresponding author: Duan Hua, Email:
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目的

探讨阴道内镜技术在门诊宫腔镜检查中的应用价值。

方法

采用前瞻性随机对照研究方法，选取2017年10月至2018年1月在首都医科大学附属北京妇产医院妇科微创中心行宫腔镜检查的400例患者为研究对象，其中行阴道内镜检查200例(研究组)、实施传统宫腔镜检查200例(对照组)，分析比较两组的检查时间、患者疼痛评分、并发症发生率、术者满意度及患者满意度。

结果

研究组的检查时间明显短于对照组[(25.47±13.03)s比(42.13±25.67)s]，差异有统计学意义(P<0.01)；研究组的患者疼痛程度视觉模拟评分法评分低于对照组[(1.88±1.58)分比(3.15±1.90)分]，差异有统计学意义(P<0.01)；研究组发生并发症的比例明显低于对照组[12/200(6%)比34/200(17%)]，差异有统计学意义(P<0.01)；按照Likert五分量表法，研究组和对照组的术者满意度为非常满意、满意、不确定、不满意和非常不满意的例数分别为64、120、12、4、0例和6、142、22、28、2例，差异有统计学意义(P<0.000)；研究组和对照组的患者满意度为非常满意、满意、不确定、不满意和非常不满意的例数分别为114、74、10、2、0例和38、118、26、16、2例，差异有统计学意义(P<0.000)；研究组和对照组的检查失败率分别为0(0/200)和1%(2/200)，差异无统计学意义(P>0.05)。

结论

阴道内镜技术微创安全、简单、高效，可明显提高患者就医满意度，值得推广应用于门诊宫腔镜检查。

关键词: 阴道内镜, 门诊宫腔镜检查, 疼痛评分
Objective

To explore the application value of vaginoscopic technology in outpatient hysteroscopy.

Methods

Using a prospective randomized controlled study method, 400 patients were selected from Oct. 2017 to Jan. 2018 in the Center of Minimally Iinvasive Gynecological Surgery of Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University, including 200 (study group) of vaginoscopy and 200 cases (control group) of traditional hystroscopy performed. The two groups were compared with examination time, patient pain score, incidence of complications, satisfaction of the practitioner and patient satisfaction.

Results

The examination time of the study group was significantly shorter than that of the control group [(25.47 ± 13.03) s vs (42.13 ± 25.67) s], The difference was statistically significant (P< 0.01); the VAS score of patients in the study group was lower than that in the control group [(1.88 ± 1.58) vs (3.15 ± 1.90)], the difference was statistically significant (P< 0.01); the incidence of complications in the study group was significantly lower than that in the control group [12/200 (6%) vs 34/200 (17%)]; the difference was statistically significant (P< 0.01); according to Likert's five subscale method, the number of patients in the study group and the control group who were very satisfied, satisfied, uncertain, dissatisfied and very dissatisfied were respectively 64, 120, 12, 4, 0 vs 6, 142, 22, 28, 2, the difference was statistically significant (P<0.000); the number of patients in the study group and the control group who were very satisfied, satisfied, uncertain, dissatisfied and very dissatisfied were respectively 114, 74, 10, 2, 0 vs 38、118、26、16、2, the difference was statistically significant (P<0.000); the failure rates of the study group and the control group were respectively 0(0/200)vs 1%(2 / 200 ), and there was no statistically significant difference (P> 0.05).

Conclusions

The vaginoscopy is safe, simple and efficient, which can significantly improve patients′ satisfaction. It is worth popularizing and applying in the outpatient hysteroscopy.

Key words: Vaginoscopy, Outpatient hysteroscopy, Pain score
表1 两组宫腔镜检查患者的基线情况比较
组别 例数 年龄(岁， ±s) 体质量指数(kg/m2， ±s) 孕(次， ±s) 产(次， ±s) 阴道分娩史[例(%)] 宫腔操作史[例(%)] 宫颈锥切术史[例(%)]
有 无 有 无 有 无
研究组 200 38.63±7.50 23.91±3.89 2.22±1.49 0.98±0.84 104(52) 96(48) 96(48) 104(52) 190(95) 10(5)
对照组 200 36.90±7.30 22.88±2.85 1.82±1.27 0.77±0.69 132(66) 68(34) 94(47) 106(53) 186(93) 14(7)
t/χ2值 ? 1.65 2.126 2.042 1.926 4.051 0.02 0.355
P值 ? 0.100 0.035 0.042 0.056 0.061 1.000 0.552
表2 两组宫腔镜检查患者的疼痛程度、检查时间及并发症比较
组别 例数 手术时间(S， ±s) VAS评分(分， ±s) 并发症[例(%)] 失败率[例(%)]
研究组 200 25.47±13.03 1.88±1.58 12(6) 0(0)
对照组 200 42.13±25.67 3.15±1.90 34(17) 2(1)
t/χ2值 ? 5.136 5.783 11.33 4.476
P值 ? <0.000 0.001 0.027 0.254
表3 两组术者满意度及患者满意度比较(例)
组别 例数 术者满意度 患者满意度
非常满意 满意 不确定 不满意 非常不满意 非常满意 满意 不确定 不满意 非常不满意
研究组 200 64 120 12 4 0 114 74 10 2 0
对照组 200 6 142 22 28 2 38 118 26 16 2
Z值 ? －5.734 －5.660
P值 ? <0.000 <0.000
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