Paulo Antonio Augusto Santos, Solheiro Maria Helena Ruivo, Paulo Carolina Oliveira Santos
Department of Obstetrics and Gynecology, Hospital Centre Tondela-Viseu, Avda. Rei D.Duarte, 3504-509, Viseu, Portugal.
Health Sciences Department, University of Aveiro, Aveiro, Portugal.
Arch Gynecol Obstet. 2015 Nov;292(5):987-94. doi: 10.1007/s00404-015-3731-0. Epub 2015 May 7.
Hysteroscopy is an indispensable approach in gynecology. Miniaturization may reduce pain allowing office procedures without anesthesia.
Our main objective is to determine if modifications in scope diameters have made office hysteroscopy less painful.
Studies were sought with key words "hysteroscopy" and "pain" from available online sources. Time frame was from 2000 onward. Thirty-three articles were retrieved for detailed analysis.
Prospective randomized trials, studying pain as main outcome in office hysteroscopy expressed in means, confidence intervals and SD, comparing office mini-hysteroscopy to conventional hysteroscopy. Studies or arms within a study where conscientious sedation, anesthesia or non-steroidal drugs were used were excluded.
We analyzed data from eight studies (seven RCT) comparing mini-hysteroscopy with conventional scopes, involving a total of twenty-three hundred and twenty-two participants, of which nineteen hundred and eighty-six completed the intervention.
A meta-analysis revealed a significant reduction pain score (MD: -3.64; 95 % CI -5.16 to -2.12; test for overall effect p < 0.00001) and available data support miniaturization decreases pain in outpatient hysteroscopy.
Pain in office hysteroscopy is lower with mini-hysteroscopes.
宫腔镜检查是妇科不可或缺的一种方法。小型化可能会减轻疼痛，使门诊手术无需麻醉。
我们的主要目的是确定宫腔镜直径的改变是否使门诊宫腔镜检查的疼痛减轻。
从可用的在线资源中搜索关键词为“宫腔镜检查”和“疼痛”的研究。时间范围为2000年起。检索到33篇文章进行详细分析。
前瞻性随机试验，以疼痛作为门诊宫腔镜检查的主要结局，用均值、置信区间和标准差表示，比较门诊微型宫腔镜检查与传统宫腔镜检查。排除使用了深度镇静、麻醉或非甾体类药物的研究或研究中的组。
我们分析了八项研究（七项随机对照试验）的数据，这些研究比较了微型宫腔镜与传统宫腔镜，共涉及2322名参与者，其中1986人完成了干预。
一项荟萃分析显示疼痛评分显著降低（MD：-3.64；95%CI -5.16至-2.12；总体效应检验p < 0.00001），现有数据支持小型化可降低门诊宫腔镜检查的疼痛。
使用微型宫腔镜时，门诊宫腔镜检查的疼痛较轻。
