宫腔镜下定点钳夹术与电切术治疗子宫内膜息肉不孕患者的效果分析

Clinical efficacy of endoscopic endometrial polyp fixation and hysteroscopic electrotomy for infertile patients with endometrial polyp

目的:分析对比宫腔镜下定点钳夹术与电切术治疗子宫内膜息肉(EP)不孕患者的效果。方法:选取92例EP不孕患者作为研究对象,按照随机数字表法分为两组,每组各46例。钳夹组行宫腔镜下定点钳夹术,电切组行宫腔镜下电切术。比较两组手术情况、住院时间、手术前后子宫内膜厚度、月经量(PBAC)评分、性生活质量、复发率及妊娠结局。结果:两组术中失血量、手术时间、住院时间比较无明显差异(P>0.05);两组术后3个月、6个月子宫内膜厚度、PBAC评分低于术前,电切组低于钳夹组(P<0.05);两组术后6个月性生活满意度、性唤起时间、获得高潮时间、每周性生活频率较治疗前显著改善,电切组优于钳夹组(P<0.05);电切组术后1年复发率低于钳夹组,宫内妊娠率高于钳夹组(P<0.05)。结论:与宫腔镜下定点钳夹术相比,宫腔镜下电切术治疗EP不孕患者可改善子宫内膜厚度与月经情况,安全性高,提高性生活质量和宫内妊娠率。

Objective:To compare the different efficacy of endoscopic endometrial polyp fixation and hysteroscopic electrotomy for infertile patients with endometrial polyp(EP).Methods:92 infertile EP patients were selected as the research objects and randomized into 2 groups,each with 46 cases.The fixation therapy group received treatment with endoscopic endometrial polyp fixation,while the electrosurgical treatment group underwent hysteroscopic electrotomy.The operative conditions,length of hospital stay,endometrial thickness before and after operation,pictorial blood loss assessment chart(PBAC)score of menstrual volume,sexual quality,recurrence rate and pregnancy outcome were compared between the two groups.Results:There was no significant difference in the amount of intraoperative blood loss,duration of operation and hospital stays between the two groups(P>0.05);the PBAC score of endometrial thickness at 3 months and 6 months after operation was lower in the two groups than before operation,and that in the electrosurgery group was lower than that in the fixation therapy group(P<0.05);sexual satisfaction,sexual arousal time,orgasm time and sexual frequency per week were significantly improved in the two groups 6 months after surgery,and the electrosurgery group was better than the fixation therapy group(P<0.05);the recurrence rate of the electrosurgery group was lower than that of the fixation therapy group,and the intrauterine pregnancy rate was higher than that of the fixation therapy group(P<0.05).Conclusion:Compared with endoscopic endometrial polyp fixation,hysteroscopic electrotomy can improve the endometrial thickness and menstrual condition in infertility patients with EP.It is of high safety,and improve the quality of sexual life and intrauterine pregnancy rate in patients.