宫腔镜电切术与腹腔镜子宫肌瘤剔除术治疗黏膜下子宫肌瘤伴不孕患者的疗效比较

Comparison of Efficacy of Hysteroscopic Resection and Laparoscopic Myomectomy For Patients with Submucosal Uterine Fibroids with Infertility

目的探讨宫腔镜电切术与腹腔镜子宫肌瘤剔除术治疗黏膜下子宫肌瘤伴不孕患者的疗效。方法选取2017年4月至2018年4月我院黏膜下子宫肌瘤伴不孕患者68例,按照手术方案不同分为宫腔镜组34例和腹腔镜组34例。宫腔镜组行宫腔镜电切术,腹腔镜组行腹腔镜子宫肌瘤剔除术。比较两组手术相关指标(术中出血量、手术时间、术后排气时间、住院时间)、术后随访1年妊娠情况、首次妊娠时间、复发情况。结果与腹腔镜组相比,宫腔镜组术中出血量较少,术后排气时间、手术时间、住院时间较短,差异有统计学意义(P<0.05);宫腔镜组妊娠率67.65%(23/34)、复发率5.88%(2/34)与腹腔镜组55.88%(19/34)、8.82%(3/34)相比,差异无统计学意义(P>0.05);宫腔镜组首次妊娠时间短于腹腔镜组,差异有统计学意义(P<0.05)。结论与腹腔镜子宫肌瘤剔除术相比,宫腔镜电切术治疗黏膜下子宫肌瘤伴不孕效果更佳,术中出血量少,手术时间、术后排气时间、住院时间、首次妊娠时间短,值得推广。

Objective To investigate the efficacy of hysteroscopic resection and laparoscopic myomectomy in the treatment of submucosal uterine fibroids with infertility.Methods A total of 68 patients with submucosal uterine fibroids with infertility from April 2017 to April 2018 were selected and divided into hysteroscopy group(n=34)and laparoscopy group(n=34)according to different surgical schemes.The hysteroscopic group underwent hysteroscopic resection,and the laparoscopic group underwent laparoscopic myomectomy.Surgery-related indicators(intraoperative blood loss,operative time,postoperative exhaust time,length of hospital stay),postoperative follow-up 1 year pregnancy time,first pregnancy time,and recurrence were compared between the two groups.Results Compared with the laparoscopic group,the intraoperative blood loss in the hysteroscopic group was less,and the postoperative exhaust time,operation time,and hospitalization time were shorter,and the differences were statistically significant(P<0.05);the pregnancy rate in the hysteroscopic group 67.65%(23/34)and recurrence rate of 5.88%(2/34)were not statistically significant compared with 55.88%(19/34)and 8.82%(3/34)of the laparoscopic group(P>0.05);The first pregnancy time in the hysteroscopic group was shorter than that in the laparoscopic group,and the difference was statistically significant(P<0.05).Conclusion Compared with laparoscopic myomectomy,hysteroscopic resection is more effective in treating submucosal uterine fibroids with infertility,with less intraoperative blood loss,surgical time,postoperative exhaustion time,hospitalization time,first time The short pregnancy time is worth promoting.