宫腔镜子宫内膜电切术治疗难治性功能失调性子宫出血的临床疗效观察

Observation on clinical efficacy of transcervical resection of endometrium in the treatment of refractory dysfunctional uterine bleeding

目的探究宫腔镜子宫内膜电切术(TCRE)治疗难治性功能失调性子宫出血的临床疗效。方法 72例难治性功能失调性子宫出血患者,随机分为观察组和对照组,每组36例。对照组患者采取左炔诺孕酮宫内缓释系统(LNG-IUS)进行治疗,观察组患者采取宫腔镜子宫内膜电切术进行治疗。对比两组患者的治疗效果。结果治疗前,两组患者的月经量比较,差异无统计学意义(P>0.05);治疗后3、6、9个月,观察组患者月经量均少于对照组,差异均具有统计学意义(P<0.05)。治疗前及治疗后3、6个月,两组患者的子宫内膜厚度比较,差异均无统计学意义(P>0.05);治疗后9个月,观察组子宫内膜厚度薄于对照组,差异具有统计学意义(P<0.05)。观察组不良反应发生率为2.8%,与对照组的5.6%比较,差异无统计学意义(P>0.05)。结论宫腔镜子宫内膜电切术治疗难治性功能失调性子宫出血效果显著,不良反应少,创伤小,子宫出血量显著减少,具有临床应用价值。

Objective To investigate the clinical efficacy of transcervical resection of endometrium（TCRE） in the treatment of refractory dysfunctional uterine bleeding. Methods A total of 72 refractory dysfunctional uterine bleeding patients were randomly divided into observation group and control group, with 36 cases in each group. The control group was treated with levonorgestrel releasing intrauterine system（LNGIUS）, and the observation group was treated with transcervical resection of endometrium. The treatment effect in two groups was compared. Results Before treatment, both groups had no statistically significant difference in menstrual volume（P〈0.05）. After 3, 6 and 9 months of treatment, the observation group had less menstrual volume than the control group, and the difference was statistically significant（P〈0.05）. Before treatment and 3 and 6 months of treatment, both groups had no statistically significant difference in endometrial thickness（P〈0.05）. After 9 months of treatment, the observation group had thinner endometrial thickness than the control group, and the difference was statistically significant（P〈0.05）. The observation group had no statistically significant difference in incidence of adverse reactions as 2.8%, comparing with 5.6% in the control group（P〈0.05）. Conclusion Transcervical resection of endometrium shows remarkable effect in treating refractory dysfunctional uterine bleeding with less adverse reactions, small trauma and significant decreased uterine bleeding. It contains clinical application value.