不同能量类型微创子宫病理手术中子宫血流参数的动态变化

O. Safronov, E. Kazachkova, E. Kazachkov, I.V. Safronovа, G.N. Mshak-Manukyan
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摘要

研究目的:分析脉冲激光和双极激光微创治疗宫内病变时子宫血流参数变化的性质。研究设计:回顾性比较研究。材料与方法。回顾性分析2016年至2020年102例手术患者的多普勒超声检查子宫血流报告,研究利用不同能量的微创宫内病理手术中子宫血流参数的动态变化。采用脉冲模式手术二极管激光治疗宫内病变60例(第一组),双极能量治疗42例(第二组)。在研究子宫血流的同时,评估左右子宫动脉阻力指数(RI)和搏动指数(PI),动脉灌注指数(API),记录子宫内膜下和子宫内膜血管血流的可能性。研究的结果。使用二极管激光手术后,IR和PI保持不变的频率比使用双极能量手术后更高,分别为75和53.34% vs 30.95和33.33%。API在第1组中升高频率更高(53.33%),在第2组中降低频率更高(66.67%),具有统计学意义。手术后子宫基底动脉和子宫盘绕动脉的血流量,二极管激光比双极激光高(分别为43.33、41.67%和21.43、19.05%)。结论。使用双极能量治疗宫内病变导致比使用二极管激光手术更严重的子宫血流障碍。这就是为什么在子宫病理的微创手术治疗中,使用脉冲模式的二极管激光器的能量是合理的。关键词:宫腔病理,宫腔镜,二极管激光,双极电极,子宫血流。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dynamics of Uterine Blood Flow Parameters in Minimally Invasive Surgeries of the Intrauterine Pathology with the Use of Various Energy Types
Study Objective: To analyze the nature of changes in the parameters of uterine blood flow in minimally invasive surgical treatment of intrauterine pathology with the use of the diode laser energy operated in pulsed mode or bipolar energy. Study Design: Retrospective comparative study. Materials and Methods. A retrospective analysis of the reports of the Doppler ultrasound examination of the uterine blood flow in 102 patients who underwent surgery in the period from 2016 till 2020 was conducted to study the dynamics of uterine blood flow parameters in minimally invasive surgeries of intrauterine pathology utilizing various types of energy. Treatment of intrauterine pathology with the use of surgical diode laser in pulsed mode was performed in 60 women (1st group), 42 women were treated with bipolar energy (2nd group). Resistance index (RI) and pulsatility index (PI) in the right and left uterine arteries, arterial perfusion index (API), possibility to register the blood flow in sub-endometrial and endometrial blood vessels were evaluated while studying the uterine blood flow. Study Results. After the surgeries performed with the use of diode laser, the IR and PI remained unchanged statistically significantly more frequently than after the surgical treatment with the use of bipolar energy: 75 and 53.34% vs 30.95 and 33.33%. API statistically significantly more frequently increased in the 1st group (53.33%) and decreased in the 2nd group (66.67%). The blood flow in basal and coiled arteries of the uterus in post-surgery period is registered statistically significantly more often if diode laser was used as compared to the surgeries performed with bipolar energy (43.33 and 41.67% vs 21.43 and 19.05%, respectively). Conclusion. The use of bipolar energy in the treatment of intrauterine pathology leads to more severe uterine blood flow disturbances than surgeries with the use of diode laser. That is why it is reasonable to use the energy of a diode laser in pulsed mode in case of minimally invasive surgical treatment of intrauterine pathology. Keywords: intrauterine pathology, office hysteroscopy, diode laser, bipolar electrode, uterine blood flow.
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