Clinical Analysis: 475 Cases Of Hysteroscopy And Hysteroscopic Surgery

Hysteroscopy is a minimally invasive diagnosis and treatment of gynecological Technology, which is to enter the medical field in China in the 20th century in the early 80. Hysteroscopic view of uterine cavity can be open and at the same time to do biopsy or surgery, is an effective way of diagnosis and treatment of intrauterine lesions. Hysteroscopic surgery with minimally invasive, pain-free open, recovered quickly, the recent incidence of low, less long-term complications, retain the uterus, does not affect ovarian function, etc., opened up an effective way of diagnosis and treatment of intrauterine disease patients which is economy, practical and simple. Hysteroscopy may be the treatment of some hemorrhagic disease, which is the past non-open under the operation of intrauterine treatment can not fully take hysterectomy Hysteroscopy retain the uterus, and even retain the ability to bear children, which to make a qualitative leap of gynecological surgery. Experienced more than 20 years of development, hysteroscopy was flourishing in China's development potential. Hysteroscopy mainly from the initial diagnosis, and for small, simple operation, to the implementation of common, more complicated surgery, the clinical application in gynecology constant depth.Objective: To investigate the indications for hysteroscopy and surgery. Hysteroscopy and surgical understanding of the disease spectrum. To investigate the accuracy of hysteroscopy. Hysteroscopy technical understanding of the clinical diagnosis and treatment of gynecological diseases application of norms of intrauterine diagnosis and treatment of disease.Methods: 475 cases of hysteroscopy or surgery patients from January 2003 to December 2008 during the First Hospital of Jilin University are analyzed retrospectively.While 432 cases of gynecological surgery before ultrason- ography, 400 cases hysteroscopic surgery for a variety of intrauterine lesions, 56 case do hysteroscopy combined laparoscopic surgery. To classify the indications and diseases of hysteroscopy, classify the type of hysteroscopy and laparoscopy combined with hysteroscopy surgery ,to compared the same rate of hysteroscopy and ultrasound examination of their results with the pathological diagnosis, use of two independent samples to compare the rate ofχ~2 test, P<0.01 considered significant difference.Results: Hysteroscopy technology has been widely used in clinical gynecology. 290 cases (61.05%) of abnormal uterine bleeding in patients with indications for hysteroscopy, 80 cases(16.84%) of abnormal intrauterine ultrasound, 31 cases (7.79%) of residual embryonic tissue. Endometrial polyps is in the first place of Hysteroscopy and surgery spectrum, followed by submucous myoma, endometrial lesions and residual embryonic tissue. Diagnosis of hysteroscopy is the gold standard cavity lesions. Hysteroscopy consistent with the pathological diagnosis is significantly higher than that the agreement of ultrasonography with the pathological diagnosis, the difference is statistically significant (P<0.01). Hysteroscopic examination in intrauterine under direct vision at the same time the situation may be abnormal intrauterine lesions for surgical treatment. 400 cases for hysteroscopic surgery, including TCRF and TCR,TCRP 202 cases (42.53%), TCRE 18 cases (3.79%), TCRM 82 cases (17.26%), TCRA 12 cases (2.52%), TCRS 21 cases (4.42%). 56 cases of laparoscopy combined with hysteroscopy patients completed a total of 116 inspections and operations, realizing the uterine cavity and pelvic lesions treated at the same time, expand a single diagnosis and treatment of gynecologic endoscopic surgery of the scope, improve accuracy of diagnosis and treatment the effectiveness of security.Conclusion: 1. Hysteroscopy in our hospital over the past two years extensive technology, the technology is more and more master of the doctors, and patients agree that women in our hospital clinical application continues to develop.2. Examinational and surgical hysteroscopy as the primary indication of abnormal uterine bleeding (AUB), Examinational and surgical hysteroscopy main diseases were endometrial polyps and submucous myoma. 3. In our study,diagnostic accuracy rate of intrauterine pregnancy organizations residues is the highest, followed by endometrial polyps in hysteroscopic diagnosis; TCRP accounted the highest proportion of distribution, followed by TCRM in hysteroscopic surgery. 4. Hysteroscopy is the role of both the diagnosis and treatment of gynecologic minimally invasive technique. 5. Hysteroscopy consistent with the pathological diagnosis is significantly higher than that the agreement of ultrasonography with the pathological diagnosis, but not a perfect substitute for Hysteroscopy Ultrasound, both joint and mutually reinforcing, can improve diagnostic accuracy. 6. Hysteroscopic and laparoscopic surgery, you can at the same time with the implementation of intrauterine diagnosis and treatment of pelvic disease, broadens the scope of gynecologic endoscopic diagnosis and treatment, to improve the accuracy of diagnosis and treatment efficacy, safety.