hysteroscopy

Hysteroscopy is a new, minimally invasive gynecological diagnosis and treatment technique for a fiber-optic endoscope for endoscopic examination and treatment, including hysteroscopy, energy systems, light source systems, perfusion systems, and imaging systems; It uses the front part of the lens body to enter the uterine cavity, and has a magnifying effect on the observed part, which is the first choice for visual and accurate diagnosis of gynecological hemorrhagic diseases and intrauterine lesions. A series of tests and treatments for women are examined, diagnosed, and analyzed by hysteroscopy. Basic Information Specialist classification: gynecological examination classification: endoscope Applicable gender: whether women are fasting: not fasting Tips: Before the operation, the oral temperature should not be lower than 37.5 degrees, and the examination or surgery should be suspended. Normal value The normal range can be given based on the horizontal comparison of the items being inspected. Clinical significance Abnormal results: B-ultrasound, uterine fallopian tube iodine angiography or diagnosis of scratching examination suggest abnormal or suspicious, can be diagnosed, verified or excluded by hysteroscopy. There are intrauterine adhesions or residual intrauterine foreign bodies, the latter including fetal bone fragments. Hysteroscopy, local biopsy combined with histopathological evaluation can help early diagnosis and timely treatment of endometrial cancer and its precancerous lesions. Suitable for inspections: 1, after more, menstrual frequency, long menstrual period, irregular uterine bleeding. 2, infertility and repeated spontaneous abortion. 3, suspected endometrial cancer and its precancerous lesions. High results may be diseases: ovarian support - stromal cell tumor, uterine effusion, cervicitis, uterine empyema, adenomyosis, fallopian tube adhesion, endometrial polyps, menstrual disease, dysfunctional uterine bleeding, uterus Inverted considerations Precautions before inspection 1, hysteroscopy is generally best in the surgery within 3-7 days after menstruation is clean. Because during this period the endometrium is thin, mucus and bleeding are less, uterine lesions are easy to see. In addition, it is not easy to make the thick inner membrane through the fallopian tube into the abdominal cavity. 2. Sex life is prohibited after menstruation or 3 days before surgery. 3, if necessary, the doctor will remind you to properly urinate before surgery, to facilitate intraoperative B-ultrasound. 4, according to the needs to do the following preoperative examination: infectious disease examination (hepatitis B surface antigen, HIVHCVRPR), liver function, kidney function, electrocardiogram, hematuria routine, coagulation four, vaginal discharge routine. 5, blood pressure, pulse, body temperature should be measured before surgery to understand cardiopulmonary conditions and vaginal cleanliness. 6, should not be checked during pregnancy, so as not to cause adverse consequences. 7, has been diagnosed as intrauterine cancer should not be checked to avoid the spread of cancer cells. 8, when there is acute genital inflammation should not be checked to prevent the spread of inflammation. 9, general in the disease activity or bleeding should not be hysteroscopy. Unless there is a medical need. Precautions after hysteroscopy 1. There may be a small amount of bloody secretions in the vagina within 2-7 days after the examination, so don't worry too much. 2, after the hysteroscopy to keep the perineum clean, do not have the same room and bath in two weeks to prevent infection. Because the cervix has not been closed tightly during this period, it is easy to invade bacteria. 3. Antibiotics to prevent infection when necessary after the examination, and to deal with the primary disease. Inspection process 1. Routine disinfection of the vulva, with sterile holes. After the local anesthesia on both sides of the cervix, the uterine cavity was placed with a sterile catheter, and a 20 ml syringe was externally placed, and the physiological saline was perfused, and the pressure was light, so that the injected physiological saline flowed out until the discharge liquid was clarified. 2. Expand the cervix and use the probe to understand the direction of the uterine cavity. Then use the black-growth strip to expand the cervix to 6.5. The domestic XG-3 fiber optic hyposcope can pass, and adjust the depth into the palace. The cavity is 7 cm deep and the upper limiter is mounted at approximately 6 cm. 3. Insert the speculum and connect it to the cold light source. Twist the light source to eliminate the air bubbles in the mirror, and then insert the speculum into the cervix, and at the same time, inject the uterine fluid, so that the mirror surface is not easy to adhere to the mucus in the case of moisture, and maintain a clear view. 4. Peeping, the front end of the speculum arrives at the end of the palace and pauses. The assistant is slightly pressurized to push the uterine fluid and slightly adjust the scope. The uterine cavity can be seen. The wall is red and yellow, and the normal endometrium is smooth. Sometimes small blood vessels are visible, and careful attention is paid to the presence or absence of lesions in the uterine cavity. By tilting the lens to the side of the palace, you can see the mouth of the fallopian tube. If necessary, take a picture and record its shape. Then slowly tilt the speculum out. In the process, the entire uterine cavity is fully visible. In the state of continued expansion, entering the cervical canal, it can be seen that the neck tube is cylindrical, yellowish white, the inner membrane is smooth and smooth, sometimes the inner membrane of the neck can be seen as longitudinal fissure, like the sulcus and interphase, sometimes visible under the uterine mucosa Myoma and cervical polyps. Not suitable for the crowd 1. Acute and subacute genital inflammation. 2. Active uterine bleeding. 3. Menstrual period and pregnancy. 4. Cervical invasive cancer. 5. The uterine cavity is too narrow. 6. Serious medical diseases. Adverse reactions and risks Damage Cervical laceration and uterine perforation may occur, but it is very rare, and the operation can be prevented by careful and gentle operation. Special care should be taken for the thin and brittle menopausal and lactating uterus. 2. Bleeding There is usually not much bleeding after surgery, especially after the microscopic examination, the cause of bleeding has been clarified, and it can be treated symptomatically. 3. Infection If there is inflammation or excessive operation, antibiotics should be given to prevent the spread of infection. If there is untreated endometrial tuberculosis, there may be tuberculosis spread after surgery, and anti-caries treatment should be strengthened. 4. Air plug If it is operated as usual, it rarely occurs. However, if the operation time is too long, the amount of CO2 perfusion in the uterine cavity is too large or too fast, it is very likely to occur. When there is shortness of breath, chest tightness and cough, stop the operation immediately and release the gas. , symptomatic treatment. 5. Cardio-cerebral syndrome Due to dilatation of the cervix, swelling of the uterine cavity, excitement of the vagus nerve, dizziness, chest tightness, sweating, nausea, pale, slow pulse, etc., similar to the phenomenon that occurs during artificial abortion, subcutaneous or intravenous injection of atropine 0.5mg, pause Surgery until the situation improves and continue to operate. 6. In extremely rare cases, due to excessive intrauterine pressure, the distally blocked fallopian tube also swells and ruptures, or due to intrauterine high-frequency current treatment, resulting in uterine perforation, intestinal perforation and other damage. 7. There are occasional reports of allergies to dextran-7 anhydride-70 and hydroxymethylcellulose. 8. After hysteroscopic operation, endometritis, endometrial cancer, and tuberculosis may spread through the fallopian tube to the abdominal cavity.