宫腔镜下刮匙刮除术和电切除术治疗子宫内膜息肉的效果比较

Comparison of Curative Effect between Hysteroscopic Curet Curettage and Electroresection in Patients with Endometrium Polyps

目的:对比评价宫腔镜下刮匙刮除术和电切除术治疗子宫内膜息肉的临床疗效。方法:选取2014年1月-2016年9月本院收治的子宫内膜息肉不孕患者140例,采用随机数字表法分为观察组和对照组,各70例。观察组采用宫腔镜下刮匙刮除术治疗,对照组采用电切除术治疗。观察并记录两组手术时间、术中出血量、术中疼痛(VAS评分)、术后住院时间;术后随访1年,记录患者术后月经量(PBAC评分)、子宫内膜厚度、子宫动脉血流(PI、RI)、复发率和妊娠率。结果:两组患者术中出血量、术中VAS评分、手术时间以及术后住院时间比较,差异均无统计学意义(P>0.05);术后3、6、12个月,两组PBAC评分均显著低于术前,且对照组均显著低于观察组,比较差异均有统计学意义(P<0.05),对照组PI及RI均高于术前及观察组(P<0.05);术后3、6个月,两组子宫内膜厚度均低于术前(P<0.05),术后12个月,对照组子宫内膜厚度低于术前(P<0.05);术后6、12个月,观察组子宫内膜厚度均高于对照组(P<0.05);术后6个月,两组复发率比较差异无统计学意义(P>0.05),但观察组妊娠率高于对照组(P<0.05);术后12个月,观察组复发率、妊娠率均高于对照组,比较差异均有统计学意义(P<0.05)。结论:宫腔镜下刮匙刮除术和电切除术均是子宫内膜息肉安全有效的治疗手段,刮匙刮除术能够更好地保护子宫的功能,提升治疗后的妊娠率,但是其术后1年复发率高,临床需要根据患者实际情况选择合适的治疗方案。

Objective：To compare and evaluate the curative effect between hysteroscopic curet curettage and electroresection in patients with endometrial polyps.Method：A total of 140 patients who diagnosed with endometrium polyp from January 2014 to September 2016 in our hospital were selected.According to the random number table method,they were divided into observation group and control group,70 cases in each group.The observation group was treated with hysteroscopic curet curettage,while control group was treated by hysteroscopic electroresection.The operation time,intraoperative bleeding volume,intraoperative pain（VAS score） and postoperative hospitalization time were observed and recorded in two groups.The postoperative menstrual volume（PBAC score）,endometrial thickness,uterine artery blood flow（PI,RI）,recurrence rate and pregnancy rate were recorded after 1 year follow-up.Result：The operation time,intraoperative bleeding volume,intraoperative pain（VAS score） and postoperative hospitalization time in two groups were compared,the differences were not statistically significant（P〉0.05）.After operation 3,6 and 12 months,the PBAC scores of two groups were lower than those before operation,and control group were lower than those of observation group,the differences were statistically significant（P〈0.05）,the PI and RI in the control group were higher than those of preoperative and observation group（P〈0.05）.After operation 3 and 6 months,the endometrial thickness of two groups were lower than those before operation（P〈0.05）,after operation 12 months,the endometrial thickness of control group was lower than that before operation（P〈0.05）,after operation 6 and 12 months,the endometrial thickness of observation group was higher than that of control group（P〈0.05）.After operation 6 months,the recurrence rate of two groups was compared,the difference was not statistically significant（P〉0.05）,the pregnancy rate in observation group was higher than that of control group（P〈0.05）.After operation 12 months,the recurrence rate and pregnancy rate of observation group were higher than those of control group,the differences were statistically significant（P〈0.05）.Conclusion：Hysteroscopic curet curettage and electroresection both have satisfactory results for patients with endometrial polyps,curet curettage can better protect the function of the uterus and improve the pregnancy rate after treatment,but the recurrence rate is high.We should select the appropriate treatment according to the patient＇s actual situation.