宫腔镜治疗子宫内膜息肉的临床疗效观察

Hysteroscopic treatment of endometrial polyps

目的探讨不同宫腔镜手术方法治疗子宫内膜息肉的临床效果。方法收集因子宫内膜息肉行宫腔镜各类手术120例。根据不同术式患者分4组,A组30例行宫腔镜定位后刮宫术组;B组30例行单纯子宫内膜息肉切除术(TCRP);C组30例行TCRP+术后辅助口服炔诺酮治疗;D组30例行经宫颈子宫内膜切除术(TCRE)。观察各组术后疗效及复发情况。结果手术时间及术中出血量D组高于其他3组,A组复发率最高;D组无1例患者发生复发。结论对于月经改变明显无生育要求者,选用TCRE疗效较好,可避免息肉复发。育龄期有生育要求者,行单纯TCRP术后效果最好,行宫腔镜定位后刮宫术术后复发率最高,对于一些多发或合并内膜息肉样增生患者,可行TCRP+术后辅助炔诺酮药物治疗。

[Objective] In order to study the efficacy and condition of recurrence of EMP taking hysteroscopic surgery. [Methods] 120 patients taked hysteroscopic surgery with EMP were included into the study. They were divided into 4 groups that based on the four different methods of treatment. group A： 30 cases take curettage after hysteroscopy positioning group： 30 cases take the transcervical resection of polyp （TCRP）; group C： 30 cases take TCRP joint use of Norethisterone; group D： 30 cases take TCRE.The efficacy and recurrence rate were studied. [Results] The amount of bleeding and the operation time in group D were more than the other groups （P 0.01）.The recurrence rate was highest in group A. There was no one case of recurrence in group D. [Conclusions] For the patients remaining potential generandi with single polyp the TCRP is the best method. For the patients with multiple polyps at the same time with endometrial hyperplasia can take TCRP joint use of norethisterone. For the patients of non-reproductiverequirements,can take TCRE, the therapeutic efficacy is higher than those of other and the recurrence rate is lower.