宫腔镜下息肉摘除术治疗子宫内膜息肉的疗效观察及其对血管内皮生长因子的影响

Clinical efficacy and impact on vascular endothelial growth factor of hysteroscopic polypectomy for treating the patients with endometrial polyps

目的探讨宫腔镜电切术治疗子宫内膜息肉的的临床疗效,以及手术方式对血管内皮生长因子(VEGF)水平的影响。方法 270例子宫内膜息肉患者分为观察组和对照组。对照组采用宫腔镜定位单纯刮宫术治疗,观察组给予宫腔镜下息肉摘除术治疗,记录术中出血量和手术时间,并于术后6、12及24个月门诊随访息肉复发情况,手术前及手术后6、12及24个月检测患者血清VEGF水平。结果两组手术均获成功,手术成功率100%。观察组术中出血量和手术时间均低于对照组,相比较差异有显著性(t=5.307,3.945,P<0.05)。观察组术后12、24个月复发率均显著低于对照组,相比较差异有显著性(t=6.91,4.005,P<0.05)。两组术后6个月复发率比较差异无显著性(t=2.081,P>0.05)。两组术后6、12及24个月血清VEGF水平显著下降,与术前比较差异均有显著性(P<0.05);两组术后6个月血清VEGF水平比较差异无显著性(t=2.043,P>0.05),术后12、24个月观察组血清VEGF水平显著低于对照组,相比较差异有显著性(t=5.233,4.907,P<0.05)。结论宫腔镜下息肉摘除术治疗子宫内膜息肉临床疗效好,并能降低子宫内膜患者血清VEGF的表达。

Abstract： [ Objective ] To investigate the clinical efficacy of hysteroscopic electrocision for treating the patients with endometrial polyps （EP）, and the impact on serum vascular endothelial growth factor（VEGF） level. [ Methods ] 270 cases of EP patients were divided randomly into the observation group and control group, the control group＇s patients were given simple curettage with orientation of hysteroscopy and the observation group＇s patients were given the hysteroscopic polypectomy therapy. The blood loss and operative time were recorded, the occurrence of EP was recorded in postoperative 6, 12, 24 months through the outpatient follow-up. Before surgery and in the postoperative 6, 12, 24 months the serum VEGF levels were detected. [Results] The operations of the two were successful, the surgical success rate was 100%. The blood loss and operative time of the observation group were lower than the con-trol group （t=5.307, 3.945, P 〈0.05）. The recurrence of EP of observation group in postoperative 12, 24 months was lower than the control group, the difference were significant （t=t=6.91, 4.005, P 〈0.05）, the recurrence of EP between the two groups was no significantly different （t=2.043, P 〉0.05）. The serum VEGF level of the observation group in postoperative 12,24 months was lower than the control group, compared with the control group the difference was sig- nificant （t=5.233,4.907, P 〈0.05）. [ Conclusion] The hysteroscopic electrocision for treating the patients with en- dometrial polyps has good clinical efficacy, and can reduce the expression of VEGF in EP patient.