宫腔镜电切除治疗子宫内膜息肉的效果及其影响因素

Effect of hysteroscopic electroresection for endometrial polyps and its influence factors

目的研究宫腔镜电切除术治疗子宫内膜息肉的效果及其影响因素。方法纳入2016年7月～2018年7月本院及另一市级三甲医院120例子宫内膜息肉患者临床资料进行回顾性分析,行宫腔镜下电切除术72例者为观察组,行宫腔镜下吸宫术者48例者为对照组,记录两组患者手术时间、术中出血量、术后住院时间及术后并发症,比较两组患者术后半年妊娠成功率、流产率及复发率。采用Logistic多因素分析法记录宫腔镜电切除术术后妊娠的独立影响因素。结果两组手术时间、术中出血量、术后住院时间及术后并发症发生率差异均无统计学意义(P>0.05);观察组妊娠成功率高于对照组,差异有统计学意义(P<0.05);两组患者流产率和复发率差异无统计学意义(P>0.05)。多因素分析结果显示年龄和息肉直径是影响患者术后妊娠成功的独立因素(OR=1.220, 1.484;P<0.05)。结论宫腔镜电切除术治疗子宫内膜息肉能显著改善妊娠结局,但妊娠结果可能受患者年龄、息肉直径的影响。

Objective To study the effect and its influence factors of hysteroscopic electroresection for endometrial polyps (EP).Methods A total of 120 EP patients from July 2016 to July 2018 in our hospital and another municipal third-class a hospital were retrospectivly analyzed.Seventy-two cases who received hysteroscopic electric resection as the observation group.Fortyeight cases who underwent hysteroscopy uterine aspiration as the control group.The operation time,intraoperative bleeding volume,post-operative hospital stay and post-operative complications of two groups were recorded.The pregnancy success rate,abortion rate and recurrence rate of 6 months after operation were compared between the two groups.The logistic multivariate analysis was used to record the independent influence factors of pregnancy after hysteroscopic electrosurgical excision.Results The difference of operation time,intraoperative bleeding volume,hospitalization time after operation and incidence of complications between the two groups were not significant (P>0.05).The pregnancy success rate of the observation group was significantly higher than that of the control group (P<0.05).The difference of abortion rate and recurrence rate between the two groups were not significant (P>0.05).The logistic multivariate analysis showed that the age and polyp diameter were the independent factors affecting the success of pregnancies after operation (OR=1.220,1.484,P<0.05).Conclusion The hysteroscopic electrosurgical excision for EP can improve pregnancy outcomes,but pregnancy outcomes may be affected by patient's age and polyp diameter.