宫腔镜下电切术与宫腔镜下刮宫术治疗异常子宫出血的疗效对比

Comparison of curative effect of hysteroscopic electroresection and hysteroscopic curettage in treatment of abnormal uterine bleeding

目的对比分析宫腔镜下电切术与宫腔镜下刮宫术治疗异常子宫出血的疗效。方法选取我院妇科2014年1月～2017年9月期间收治的236例异常子宫出血患者,所有患者均于宫腔镜下进行手术治疗,按照不同术式将其分为电切术组(104例)与刮宫术组(132例),对比两组患者的病因及检出率、临床疗效、手术相关指标、并发症发生情况以及病灶复发情况。结果电切术组的病因检出率为87.5%,刮宫术组为81.8%,电切术组略高于刮宫术组,对比差异无统计学意义(P> 0.05)。电切术组的总有效率为97.1%,刮宫术组为84.8%,电切术组明显高于刮宫术组,对比差异有统计学意义(P <0.05)。对比两组患者的手术相关指标,电切术组的手术时间、术中出血量以及住院时间均略多于刮宫术组,对比差异无统计学意义(P> 0.05)。电切术组的并发症发生率为5.8%,刮宫术组为9.7%,电切术组明显低于刮宫术组,对比差异有统计学意义(P <0.05)。电切术组的病灶复发率为6.7%,刮宫术组为12.1%,电切术组明显低于刮宫术组,对比差异有统计学意义(P <0.05)。结论宫腔镜下电切术治疗异常子宫出血的疗效优于宫腔镜下刮宫术治疗,具有病因检出率高、并发症发生率低、复发率低等优势,值得临床大力推广与应用。

Objective To compare the curative effect of hysteroscopic electroresection and hysteroscopic curettage in treatment of abnormal uterine bleeding.Methods 236 patients with abnormal uterine bleeding who were admitted and treated in the Department of Obstetrics and Gynecology of our hospital from January 2014 to December 2017 were selected and all patients were given operation under hysteroscopy.According to different surgical methods,they were divided into electroresection group(104 cases)and curettage group(132 cases).Etiology,detection rate,clinical curative effect,surgery related indicators,complications and recurrent lesions of the two groups were compared.Results The detection rate of etiology in the electroresection group and the curettage group was respectively 87.5%and 81.8%.The detection rate of etiology in the electroresection group was higher than that of the curettage group,and the comparative difference was not statistically significant(P>0.05).The total effective rate of the electroresection group and the curettage group was respectively 97.1%and 84.8%.The total effective rate of the electroresection group was significantly higher than that of the curettage group,and the comparative difference was statistically significant(P<0.05).The operative time,intraoperative blood loss and hospital stay in the electroresection group were all slightly more than that in the curettage group,and the comparative difference had no statistically significance(P>0.05).The incidence of complications in electroresection group was 5.8%,significantly lower than that in the curettage group was 9.7%,and the difference was statistically significant(P<0.05).The rate of recurrent lesions in the electroresection group was 6.7%,significantly lower than that of the curettage group 12.1%and the difference was statistically significant(P<0.05).Conclusion The curative effect of hysteroscopic electroresection in treatment of abnormal uterine bleeding is better than that of hysteroscopic curettage.It has the advantages of high detection rate of has the advantages of high detection rate of etiology,low incidence of complications and low recurrence rate,which is worth popularizing and applying in clinical practice.