宫腔镜下不同术式治疗子宫内膜息肉疗效观察

Hysteroscopy under different operative treatment of endometrial polyp curative effect observation

目的探讨宫腔镜下不同手术方法治疗子宫内膜息肉的临床疗效及术后预防复发方法。方法收集子宫内膜息肉行宫腔镜检查及手术患者168例。用随机表法分为3组,A组56例行宫腔镜定位后行息肉摘除加全面刮宫术;B组54例行宫腔镜下子宫内膜息肉电切术;C组58行宫腔镜下子宫内膜息肉电切术,术后服用炔诺酮治疗3个周期。三组均随诊2年,记录患者子宫内膜息肉的复发情况、月经量情况及再次宫腔镜检查结果等,并作组间比较。结果 A组复发率最高,复发率37.50%(21/56);B组复发率次之,为7.41%(4/54);C组复发率最低,为1.72%(1/58)。三组比较,差异有统计学意义(P<0.05)。结论宫腔镜下子宫内膜息肉电切术治疗子宫内膜息肉疗效优于宫腔镜定位后行息肉摘除加全面刮宫术,行宫腔镜下子宫内膜息肉电切术并术后应用孕激素治疗更有助于治疗及预防子宫内膜息肉的复发。

Objective To explore hysteroscopy under different operation methods in the treatment of endometrial polyps clinical curative effect and postoperative relapse prevention method. Methods Examined by hysteroscopy and endometrial polyps in 168 cases patients with operation Random table method is divided into 3 groups, group A in 56 cases after hysteroscopic polypectomy positioning comprehensive curettage ; 54 in group B underwent hysteroscopic endometrial polyp electrocision; group C 58 lines of hysteroscopic endometrial polyp re- section, postoperative use of norethindrone on 3 cycle The three groups were followed up for 2 years, records of patients with endometrial polyp recurrence, menses amounts and again hysteroscopy results, and make a com- parison between groups. Results In A group the highest relapse rate, recurrence rate was 37.50% （21/56） ; recurrence rate in B group the second, 7.41% （4/54） ,the lowest recurrence rate in C group, 1.72% （1/58） Comparison of the three groups, there were significant differences （P 〈 0. 05）. Conclusion Hysteroseopic endometrial polyp electrocision therapy of endometrial polyps after polypectomy positioning effect is better than that of hysteroscopy and complete curettage, line of hysteroscopic endometrial polyp electrocision and postoperative application of progestin therapy is more helpful for the treatment and prevention of recurrence of uterine endometrial polyps.