宫腔镜下电切术与刮除术治疗子宫内膜息肉效果比较

EFFECTIVENESS OF ELECTRICAL RESECTION VERSUS CURETTAGE OF ENDOMETRIAL POLYPS UNDER HYSTEROSCOPY

目的比较宫腔镜下电切术与宫腔镜定位下刮除术治疗子宫内膜息肉的临床效果。方法子宫内膜息肉病人110例,随机分为两组,各55例。对照组实施宫腔镜定位下刮除术,观察组实施宫腔镜下电切术。比较两组病人的手术时间、出血量、月经量、血红蛋白含量、治疗后1年复发率及妊娠率。结果观察组手术时间及出血量均明显少于对照组,差异有显著性（t=7.592、11.352,P〈0.05）。治疗后两组病人的月经量较治疗前明显降低,血红蛋白含量较治疗前明显升高,差异有显著性（t=5.473~9.578,P〈0.05）。治疗后观察组病人的月经量较对照组明显降低,血红蛋白含量较对照组明显升高,差异有显著性（t=5.321、4.634,P〈0.05）。治疗后1年观察组复发率明显低于对照组,观察组妊娠率明显高于对照组,差异均有显著性（χ~2=13.982、9.878,P〈0.05）。结论宫腔镜下电切术治疗子宫内膜息肉可明显缩短手术时间,减少术后出血量、月经量及复发率,提高血红蛋白含量和妊娠率,值得临床推广与应用。

Objective To compare the clinical efficacy between electrical resection and uterine curettage for endometrial polyps（EP）under hysteroscopy. Methods A total of 110 patients with EP were enrolled and equally divided into observation group and control group in random.Patients in the control group underwent curettage under hysteroscopy,and those in the observation group underwent electrical resection under hysteroscopy.A comparison was made between the two groups with regard to operation time,amount of blood loss,volume of menstrual flow,hemoglobin content,as well as recurrence rate and pregnancy rate after one year of therapy. Results The operation time was shorter and the amount of blood loss was less in patients of the observation group versus that of the control（t=7.592,11.352;P〈0.05）.After therapy,the menstrual volume of patients in both groups declined,and hemoglobin content increased,the differences in that before therapy were significant（t=5.473-9.578,P〈0.05）.Menstrual volume of patients in the observation group,after therapy,was decreased versus that in the control group,and hemoglobin increased（t=5.321,4.634;P〈0.05）.One year after therapy,the recurrence rate was lower and the pregnancy rate higher in patients of the observation group versus that of the control group,the differences were statistically significant（χ~2=13.982,9.878;P〈0.05）. Conclusion Electrical resection of endometrial polyps under hysteroscopy can obviously shorten the operation time,reduce post-operative blood loss,menstrual volume and recurrence rate,and increase hemoglobin and pregnancy rate.This procedure is worthy of clinical popularization and application.