ABSTRACT
Objective To compare the clinical effect about hysteroscope and laparotomy in patients with submucous uterine myoma. Methods Eighty-four patients with submucous uterine myoma were randomly divided into control group(n=42)and observation group(n=42). The patients in the control group were given laparotomy treatment,while in the observation group were given hysteroscope treatment. The intraoperative and postoperative conditions between the two groups were recorded and compared. Results The operation time, intraoperatve blood volume,postoperative anal exhaust time,postoperative pain intensity( judged by VAS)and hospital stays periods in observation group were(52. 5 ± 9. 6)min,(84. 6 ± 16. 7)ml,(21. 5 ± 3. 6)h,(3. 6 ± 1. 4)scores and(5. 4 ± 1. 8)d,significant lower than those in control group((72. 6 ± 13. 4)min,(116. 8 ± 28. 4)ml,(29. 8 ± 5. 4)h,(1. 8 ± 0. 5)scores,(9. 6 ± 2. 4)d),and the differences were significant( t=5. 468,4. 263,4. 438,6. 283;P =0. 006,0. 018,0. 024,0. 001,0. 002 ). While the hospitalization costs in observation group was(7394. 9 ± 1164. 8)yuan,higher than that of the control group((5 428. 9 ± 824. 5) yuan;t=4. 647,P=0. 036). There were no statistical significant in terms of recurrence rate between the two groups( 20. 5% vs. 19. 6%;χ2 = 0. 236,P = 0. 637 ). Conclusion Treatment of hysteroscope surgery on submucosal myoma of uterus has the advantages of small trauma and quick recovery and it is an ideal surgical method for uterine myoma.
ABSTRACT
Objective To study the diagnostic value of endoscopic retrograde cholangiopancreatography (ERCP) combined with intraductal ultrasonography (IDUS) for bile duct stricture diseases.Methods The results of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography,intraductal uhrasonography,bile duct brushing cytology,the liquid-based cytology and the histopathological examination were analyzed retrospectively.The final diagnosis was made based on clinical data,histopathology and follow-up results(≥4 months).Results Twenty-one patients were diagnosed as having malignant biliary diseases,including 9 biliary tract carcinoma,4 duodenal papilla carcinoma,4 pancreatic cancer infiltrated common bile duct,4 cancer of the liver infiltrated common bile duct ; 15 were diagnosed as having benign biliary diseases,including 9 bile duct stones,4 liver fluke disease,lbile duct inflammatory stenosis,1 bile duct stricture caused by external compression.The accuracy rate of the EUS,ERCP,IDUS and ERCP + IDUS in the differential diagnosis of the bile duct stricture disease were 77.8％,88.9％,91.7％ and 94.4％,respectively.The accuracy rates of IDUS,ERCP,ERCP combined with IDUS were significantly higher than that of EUS (P ＜ 0.05).The sensitivity,specificity,positive predictive value and negative predictive value of ERCP combined with IDUS were 95.2％,93.3％,95.2％ and 93.3％ respectively which were higher than those of EUS,ERCP and IDUS.After the bile duct brushing cytology and the liquid-based cytology or histopathological examination,19 patients were diagnosed as having malignant biliary diseases,17 were benign biliary diseases.The sensitivity,specificity and accuracy of the procedures for malignant bile duct stricture disease were 90.5％,100.0％,94.4％ respectively.Conclusion ERCP combined with IDUS can improve the diagnostic accuracy.The diagnostic positive rate will be higher with the help of ERCP,IDUS and targeted brush.