目的 探讨日间手术模式下宫腔镜技术诊治常见妇科疾病的效果.方法 回顾性分析2 744例常见妇科疾病患者的临床资料.所有患者均在日间手术室完成宫腔镜手术,总结患者的手术情况、麻醉及术后并发症发生情况、住院费用及患者满意度.结果 2 744例患者手术过程均顺利.术中提示重度宫腔粘连患者182例,直接转住院治疗;术中提示双侧输卵管病变且有生育要求的患者388例,建议住院处理输卵管积水后再行辅助生殖技术;术后病理提示子宫内膜样腺癌4例,子宫内膜不典型增生9例,怀疑子宫内膜结核2例,均建议住院治疗.有8例(0. 3% )患者出现较严重麻醉并发症,对症处理后均缓解且当日出院.符合出院标准的2 562例患者于当天办理出院.平均住院总费用为(1 902. 04 ± 824. 96)元.随访期间患者均未出现严重并发症,满意度为100% .结论 日间手术模式下,宫腔镜技术更能体现其在妇科疾病中的应用价值,不仅能用于治疗常见疾病并快速评估患者病情,还能尽早发现癌前病变或早期癌症,有利于及时决策下一步治疗方案.%Objective To explore the effect of ambulatory hysteroscopic surgery applied to diagnosis and treatment of common gynecological diseases. Methods The clinical data of 2 744 patients with common gynecological diseases were retrospectively analyzed. All patients received hysteroscopic procedures in the ambulatory surgery room. The surgical procedure,anesthetic and postoperative complications, hospitalization cost and patients′satisfaction were summarized. Results The surgeries were completed successfully in the 2 744 cases. A total of 182 patients were intraoperatively diagnosed as severe intrauterine adhesions and were directly required to be hospitalized. A total of 388 patients with demand for fertility were intraoperatively diagnosed as bilateral fallopian tube lesions and were advised to have assisted reproductive technology after the treatment of salpingian dropsy during hospitalization. Four cases were diagnosed as endometrial adenocarcinoma and 9 cases as endometrial atypical hyperplasia by postoperative pathology,and 2 cases were suspected as endometrial tuberculosis. Those 11 patients above were also advised to be hospitalized. Eight patients(0. 3% ) suffered from severe anesthetic complications,but were recovered after symptomatic treatment and were discharged on the same day. A total of 2 562 patients reached the discharge standard and were discharged on the same day. The mean total hospitalization cost was 1 902. 04 ± 824. 96 yuan. No severe complications occurred during the follow-up. The satisfaction degree was 100% . Conclusion The ambulatory hysteroscopic surgery not only can treat the common gynecological diseases,quickly assess the severity of disease,presenting its application value for gynecological diseases more significantly,but also can find out the precancerous or early cancer lesion as early as possible. And it is benefit to the early decision for next treatment plan.
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