经阴道内镜手术在无性生活生育年龄女性子宫内病变的临床应用

doi:10.3969/j.issn.1006-7795.2022.04.023

首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (4): 658-663.doi: 10.3969/j.issn.1006-7795.2022.04.023

经阴道内镜手术在无性生活生育年龄女性子宫内病变的临床应用

李云飞, 黄晓武^*, 夏恩兰

首都医科大学附属复兴医院宫腔镜中心,北京 100038

收稿日期:2021-12-20 出版日期:2022-08-21 发布日期:2022-10-28

Clinical application of transvaginal endoscopic surgery in intrauterine lesions in women of childbearing age with asexual life

Li Yunfei, Huang Xiaowu^*, Xia Enlan

Hysteroscopy Center, Fuxing Hospital, Capital Medical University, Beijing 100038, China

Received:2021-12-20 Online:2022-08-21 Published:2022-10-28
Contact: *E-mail:hxiaowu_fxyy@126.com

摘要/Abstract

摘要： 目的探讨经阴道内镜手术对无性生活的生育年龄患者子宫内病变的临床诊治与手术技巧。方法回顾性分析2017年1月至2021年1月首都医科大学附属复兴医院收治的无性生活生育年龄患者152例,行宫腔镜检查和或手术及病理组织学检查。结果 152例患者均成功实施经阴道宫腔镜手术,顺利切除宫腔内或宫颈良性病变和镜下子宫内膜定位活检,无宫颈裂伤、子宫穿孔、经尿道前列腺电切术(transurethral resection of prostate,TURP)综合征等并发症,处女膜医源性擦伤或裂伤16例(10.5%)。结论经阴道内镜宫腔镜手术可以在有效保护处女膜的前提下,及时准确地早期诊治宫腔内病变,有效保护其生育潜力。

关键词: 经阴道内镜手术, 宫腔镜检查, 病理组织学检查

Abstract: Objective To explore the clinical diagnosis, treatment and surgical skills of transvaginal endoscopic surgery for intrauterine lesions in reproductive age patients with asexual life. Methods Totally 152 patients, who were under childbearing age with asexual life and treated in Fuxing Hospital Affiliated to Capital Medical University from January 2017 to January 2021, were analyzed retrospectively. They underwent hysteroscopy and/or surgery and histopathology. Results Transvaginal hysteroscopy was successfully performed in all 152 patients. Benign intrauterine or cervical lesions were successfully removed. Endoscopic endometrial biopsy was sufficiently performed. There were no complications such as cervical laceration, uterine perforation and transurethral resection of prostate (TURP). There were 16 cases (10.5%) of iatrogenic abrasion or laceration of hymen. Conclusion Transvaginal endoscopic hysteroscopy can be used to timely and accurately diagnose and treat intrauterine lesions and effectively protect their reproductive potential on the premise of effective protection of hymen.

Key words: transvaginal endoscopic surgery, hysteroscopy, histopathology examination

中图分类号:

R816.91

李云飞, 黄晓武, 夏恩兰. 经阴道内镜手术在无性生活生育年龄女性子宫内病变的临床应用[J]. 首都医科大学学报, 2022, 43(4): 658-663.

Li Yunfei, Huang Xiaowu, Xia Enlan. Clinical application of transvaginal endoscopic surgery in intrauterine lesions in women of childbearing age with asexual life[J]. Journal of Capital Medical University, 2022, 43(4): 658-663.

参考文献

[1] Smorgick N, Padua A, Lotan G, et al. Diagnosis and treatment of pediatric vaginal and genital tract abnormalities by small diameter hysteroscope[J]. J Pediatr Surg, 2009, 44(8):1506－1508.
[2] 朱可安, Johary J, 徐大宝. 应用宫腔镜诊治幼女和少女妇科疾病[J]. 国际妇产科学杂志, 2014, 41(5):545－549.
[3] 易水晶, 王晓霞, 金琳, 等. 156例行阴道内镜诊治的幼女和青春期少女临床资料分析[J]. 中南大学学报:医学版, 2019, 44(9):1030－1034.
[4] 李瑞娟, 夏恩兰. 阴道内镜与传统宫腔镜检查临床应用的比较[J]. 中国内镜杂志, 2015, 21(10):1019－1022.
[5] 彭燕蓁, 段华, 成九梅, 等. 阴道内镜技术在门诊宫腔镜检查中的应用价值[J]. 中华腔镜外科杂志: 电子版, 2020, 13(1):36－40.
[6] 李晴晴, 王晓东, 韩璐. 宫腔镜电切术治疗无性生活女性黏膜下肌瘤4例[J]. 中国微创外科杂志, 2016, 16(7):648－649, 660.
[7] 冯小丹, 曾莉, 丁易钤. 宫腔镜处理无性行为女性子宫内膜息肉外阴脱出1例[J]. 实用妇科内分泌电子杂志, 2019, 6(21):25.
[8] Khorrami H, Rackow B W. Hysteroscopic resection of a symptomatic uterine leiomyoma in an adolescent[J]. J Pediatr Adolesc Gynecol, 2011, 24(5):e111－e114.
[9] Fascilla F D, Olivieri C, Cannone R, et al. In-office hysteroscopic treatment of Herlyn-Werner-Wunderlich syndrome: a case series[J]. J Minim Invasive Gynecol, 2020, 27(7):1640－1645.
[10] 全国卫生产业企业管理协会妇幼健康产业分会生殖内分泌学组. 中国子宫内膜增生诊疗共识[J]. 生殖医学杂志, 2017, 26(10):957－960.
[11] 中华医学会妇产科学分会妇科内镜学组. 宫腔镜手术子宫颈预处理临床实践指南[J]. 中华妇产科杂志, 2020, 55(12):813－818.
[12] 许霄. 间苯三酚于宫腔镜术中的应用效果观察[J]. 现代医用影像学, 2019, 28(2):387－388.
[13] Nakhal R S, Wood D, Creighton S M. The role of examination under anesthesia (EUA) and vaginoscopy in pediatric and adolescent gynecology: a retrospective review[J]. J Pediatr Adolesc Gynecol, 2012, 25(1):64－66.
[14] Davis V J, Dizon C D, Minuk C F. Rare cause of vaginal bleeding in early puberty[J]. J Pediatr Adolesc Gynecol, 2005, 18(2):113－115.
[15] 王霞. B超监护下宫腔镜手术的临床疗效和安全性观察[J]. 影像技术, 2018, 30(1):41－43.
[16] 戴晨燕, 胡娅莉, 朱湘虹, 等. 经腹部超声实时引导在重度宫腔粘连宫腔镜手术中的应用价值[J]. 中华医学超声杂志: 电子版, 2020, 17(5):447－450.
[17] Marnach M L, Laughlin-Tommaso S K. Evaluation and management of abnormal uterine bleeding[J]. Mayo Clin Proc, 2019, 94(2):326－335.
[18] Dueholm M, Hjorth I M. Structured imaging technique in the gynecologic office for the diagnosis of abnormal uterine bleeding[J]. Best Pract Res Clin Obstet Gynaecol, 2017, 40: 23－43.
[19] Royal College of Obstetricians ＆ Gynaecologists. Management of endometrial hyperplasia (green-top guideline No. 67)[R/OL]. (2021-12-20)[2022-06-01].https://rcog.org.uk/media/knmjbj5c/gtg_67_endometrial_hyperplasia.pdf.
[20] 陈晓军, 杨佳欣, 王华英, 等. 子宫内膜非典型增生和早期子宫内膜样癌的保留生育功能治疗及评估的建议[J]. 中华妇产科杂志, 2019, 54(2):80－86.
[21] 白瑜, 靳松, 杨业洲. 子宫内膜非典型增生及早期子宫内膜癌生育力保留与生育实现策略[J]. 中国计划生育和妇产科, 2020, 12(10):25－28, 33.
[22] 文斌. 宫腔镜联合孕激素治疗子宫内膜非典型增生患者临床效果及对复发率的影响[J]. 吉林医学, 2020, 41(8):1919－1921.
[23] 范源, 田莉, 王建六. 早期子宫内膜癌及子宫内膜非典型增生患者保留生育功能治疗后子宫内膜容受性研究进展[J]. 中国妇产科临床杂志, 2021, 22(6):663－665.

经阴道内镜手术在无性生活生育年龄女性子宫内病变的临床应用

Clinical application of transvaginal endoscopic surgery in intrauterine lesions in women of childbearing age with asexual life

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