宫腔镜子宫内膜电切术治疗难治性功能失调性子宫出血患者的效果观察

Effect of hysteroscopic endometrial electrotomy in treatment of patients with refractory dysfunctional uterine bleeding

目的探讨宫腔镜子宫内膜电切术治疗难治性功能失调性子宫出血患者的效果。方法将98例难治性功能失调性子宫出血患者随机分为对照组与研究组各49例。对照组患者在阴道内置入左炔诺孕酮宫内节育系统治疗,研究组应用宫腔镜子宫内膜电切术治疗。比较2组治疗前与治疗6个月子宫内膜厚度、月经量、性激素指标[血清促黄体生成素(LH)、雌二醇(E2)、卵泡刺激素(FSH)]、血红蛋白水平(Hb)的变化以及不良反应发生情况。结果治疗6个月后,研究组子宫内膜厚度、月经量显著小于、少于对照组(P <0. 01)。治疗6个月后,对照组LH与FSH水平显著高于研究组(P <0. 01),E2水平显著低于研究组(P <0. 01)。治疗6个月后,研究组Hb水平显著高于对照组(P <0. 01)。研究组不良反应发生率2. 04%,显著低于对照组16. 33%(P=0. 014)。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确切,可以有效改善患者的症状,纠正Hb水平,且对卵巢功能无明显影响。

Objective To explore the effect of hysteroscopic endometrial electrotomy in the treatment of patients with refractory dysfunctional uterine bleeding.Methods A total of 98 patients with refractory dysfunctional uterine bleeding were selected and randomly divided into control group and study group,with 49 cases in each group.Patients in the control group were treated with levonorgestrel intrauterine contraceptive system in the vagina,while patients in the study group were treated with hysteroscopic endometrial electrotomy.The endometrial thickness,menstrual volume,sex hormone indexes[serum luteinizing hormone(LH),estradiol(E2),follicle stimulating hormone(FSH)],hemoglobin level(Hb)and adverse reactions were compared between the two groups before treatment and 6 months after treatment.Results After 6 months of treatment,the endometrial thickness and menstrual volume of the study group were significantly smaller and less than those of the control group(P<0.01).After 6 months of treatment,the levels of LH and FSH in the control group were significantly higher than those in the study group(P<0.01),and the level of E2 was significantly lower than that in the study group(P<0.01).After 6 months of treatment,the Hb level in the study group was significantly higher than that in the control group(P<0.01).The incidence rate of adverse reactions in the study group was 2.04%,which was significantly lower than 16.33%in the control group(P=0.014).Conclusion Hysteroscopicendometrial electrotomy is effective in the treatment of patients with refractory dysfunctional uterine bleeding,which can not only effectively improve the symptoms of patients,correct the level of Hb,but also has no significant impact on the levels of sex hormones.