| Objective This study is aimed to understand the development of the hysteroscopic surgery which is used to treat the gynecological diseases in recent years,to discuss the significance of hysteroscopy and endometrial biopsy in the diagnosis of benign and malignant uterine lesions,and to understand the guiding significance of the hysteroscopy before surgery,to understand the incidence of the complications of hysteroscopic surgery,and to explore the related factors,so as to strengthen the prevention of complications.Methods 6234 cases of hysteroscopy surgery were retrospectively analyzed from January 2007 to December 2016 in affiliated hospital of Qingdao university.1.Collect the cases of hysteroscopic surgery to understand the development of hysteroscopic surgery in clinical application.2.Analysis the number of various indications of hysteroscopic surgery to understand their ratio and the tendency of the treatment in recent years.3.Calculate the number of the result of the pre-op or post-op pathology to explore the necessity of preoperative hysteroscopy.4.Through the analysis of complications of hysteroscopic surgery,the related factors of surgical complications were understood.SPSS 24.0 statistical analysis software was used for statistical processing.The analysis of the results of the test is based on chi-square test,which is statistically significant for the P < 0.05.Result 1.The number of hysteroscopic surgeries in our hospital has increased gradually over the past 10 years,especially in the past three years.2.Indications of hysteroscopy surgery in the 6234 cases include 3546 cases of endometrial polyps samples(56.88%),2141 cases of submucosal leiomyomas(34.34%),295 cases of the uterus mediastinal(4.73%),174 cases of intrauterine adhesions(2.79%),38 cases of the intrauterine device ectopic(0.61%),7 cases of atypical endometrial hyperplasia(0.11%),5 cases of endometrial carcinoma(0.08%).3.Among the 6234 cases,5776 cases had biopsy pathological examination results.The results include 2905 cases of endometrial polyps are(50.31%),2140 cases of submucosal leiomyoma and adenomyoma(37.04%),33 cases of atypical endometrial hyperplasia(0.57%),15 cases of endometrial cancer(0.26%).4.In the 5776 cases,the preoperative hysteroscopy and endometrial biopsy were performed in 5154 patients,of which 5142 cases were benign,and the results of atypical hyperplasia and endometrial cancer were 10 cases.Among the 5154 cases,there were 38 cases of endometrial carcinoma and endometriosis.There were 622 cases without hysteroscopy and endometrial biopsy,and 10 cases of endometrial cancer and endometrial hyperplasia were diagnosed after hysteroscopic surgery.Preoperative hysteroscopy and endometrial biopsy were statistically significant that were used to diagnose endometriosis and endometrial carcinoma.(c2=6.67,P < 0.05).5.Common complications of hysteroscopic surgery include 8 cases of uterine perforation,16 cases of hemorrhage,7 cases of TURP syndrome,and the ratio of complications of hysteroscopic surgery is 0.50%.The incidence of complications of the first and secondar class surgery was 0.10%(4/3895),and the one of third and forth class was 1.15%(27/2339).The campare of two groups has statistically difference(c2=32.26,P<0.001).According to the the time the surgen engaged in hysteroscopy surgery,the cases were divided into 2 groups,including the surgen who engaged in hysteroscopy surgery time less than 5 years and that engaged more than 5 years.The complication rate of the front group was 0.62%(18/2922),and the post one was 0.30%(13/4312),comparing the two groups have statistical significance(c2 =10.70,P=0.001).Complications of postmenopausal patients and complications in patients with menopause were statistically difference(c2 =5.36,P<0.05).Conclusion 1.With the progress of hysteroscopy in the last 10 years,the number of patients undergoing hysteroscopic surgery has gradually increased.2.Hysteroscopic surgical indications are mainly endometrial polyps,submucosal myoma,and intrauterine adhesions.3.It is important to judge the benign and malignant lesions in uterine cavity by preoperative hysteroscopy and endometrial biopsy.Hysteroscopy can be used as a routine examination before surgery.4.The complication rate of hysteroscopic surgery is very low,and the incidence of complications is related to the experience of the surgeon,the complexity of the operation,and the patient’s pausimenia.The risk factors for the complications were less experienced,difficult surgery,and postmenopausal patients. |
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