vacuum suction curettage

Curettage is a process of scraping and collecting endometrial tissue in the uterus. Surgical purposes: Diagnostic biopsy; Treatment of irregular uterine bleeding; Removal of embryonic tissue for abortion or treatment of incomplete spontaneous abortion. Treatment of diseases: abortion Indication Applicable to those within 10 weeks of pregnancy. Preoperative preparation 1, item preparation, such as voyeurism, 1-8 cervical dilator, long scorpion, cervical pliers, uterus probe, scale suction tube (3-7), curette, measuring cup and screen, medium bend Plate, rubber tube and rubber joint, disinfection hip pad, one piece of sponge towel, gauze, cotton ball, cotton swab, vacuum suction device, disinfectant. 2. Introduce the surgery to the subject and relieve the ideological concerns. 3, ask the medical history, check the heart, lungs, measure blood pressure, test blood routine, out, clotting time, blood type. Platelet counts were made if necessary. Gynecological examination, to understand the size and location of the uterus, whether there is inflammation in the pelvic cavity, vaginal secretions to check trichomoniasis, mold, cleanliness. 4. Empty the bladder. Surgical procedure 1. The lithotomy position is routinely disinfected for vulva and vagina, and sterile towels are placed. Check the size, position, tilt and attachment of the vagina and uterus for abnormalities. Use a vaginal speculum to dilate the vagina, expose the cervix, wipe off the secretions from the cervix, and disinfect the cervix and cervical canal with iodine and ethanol. Clamp the anterior lip of the cervix and pull the cervical forceps horizontally to reduce the angle between the uterus and the cervix. Support the cervical pliers with the left hand, hold the uterus probe with the right hand, gently penetrate into the uterine cavity in the direction of the uterus and go straight to the bottom of the palace. Measure the depth of the uterine cavity and gently swing it to the sides to estimate the width of the uterine cavity. 2, disinfection of the vulva, a vaginal internal examination after the towel to clear the location and size of the uterus. 3, detect the uterine cavity, use the vaginal speculum to open the vagina, expose the cervix, disinfect the cervix and cervical canal with iodine, ethanol, clamp the anterior lip of the cervix, fix the cervical pliers with the left hand, hold the uterus probe with the right hand, press the uterus The direction of the tilting direction detects the depth of the uterine cavity and further determines the degree of uterine flexion. 4, dilate the cervix, the left hand holding the cervical pliers to pull outward, the right hand-held dilator to expand the cervix according to the direction of the uterus that has been detected, the degree of expansion can be determined according to the thickness of the suction tube required, generally from the 3-4 At the beginning, the half number is incremented in turn, and the number is expanded to 6-7 (the larger half of the straw used). In the 6th week of pregnancy, the suction tube is used on the 3rd. Generally, the cervix is not dilated. After the mother and the cervix in the 8th week of pregnancy, the 5th straw is used, and the cervix is often not needed. The internal cervix is tight, and those with difficulty in expansion should not be forced to expand. You can use 1% procaine or 1%-2% lidocaine for bilateral injections on the sides, 3-5ml on each side, and then slowly expand. 5, vacuum suction (1) Selection of the suction tube: The depth of the uterine cavity that has been detected can be used as a reference for selecting the suction tube. General uterine cavity <10cm, can be used 3-5 suction tube, 10-11cm can be used on the 6th, 11.5-12.5cm can be used on the 7th, >12.5cm, apply the 8th suction tube. (2) Adjusting the negative pressure: adjust the negative pressure of the vacuum suction device to 53.0-66.0 kPa (400-500 mmHg), connect one end of the rubber tube to the suction tube, and the other end is connected to the liquid storage of the vacuum suction device by the assistant. On the bottle, first carry out the negative pressure test, put the suction tube into the sterile water cup, the water is sucked or the side hole of the suction tube is blocked by the ventral side of the finger, and the finger is attracted by the suction force, and it is confirmed that it is negative pressure, and then closed. Attractor. (3) Attraction: gently put the direction of the suction tube into the uterine cavity, and then exit 1.5-2cm at the bottom of the palace. The side hole of the suction tube is directed to the front and rear walls of the uterine cavity to find the embryo implantation site, and the negative pressure is attracted. The suction tube is moved up and down from the bottom of the palace to the end of the uterus. When the suction tube to the hand gives a sense of vibration, it is a sign that the embryo and the villi are inhaled, and then gently attracts the peripheral wall of the uterine cavity. When the activity is limited, it means that the pregnancy has been sucked, the negative pressure is closed, and the suction tube is taken out. If necessary, use a small curette to gently scrape the bottom of the palace and the two corners to check whether it is sucked, and then use the probe to measure the size of the uterine cavity to understand the uterine contraction. 6, remove the cervical forceps, wipe the cervix, blood in the vagina, make the cervix reset, remove the vaginal device, wipe the vulva and hip blood, pad disinfection pad. 7. Check the aspirate. Pour the aspirate into the filter or put it into a container of water, check for fluff and embryos to determine if the abortion is complete, measure the amount of bleeding, and if there is any suspicious scraping, you should send a pathological examination. Fill in the surgical record and special circumstances should be recorded in detail. complication Postoperative intrauterine infection.

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