宫腔镜刨削系统在子宫内膜息肉治疗中的应用价值

Clinical value of hysteroscopic morcellator system in the treatment of endometrial polyps

目的分析宫腔镜刨削系统治疗子宫内膜息肉的临床价值。方法选择2019年4月至2020年4月深圳市宝安区福永人民医院妇科收治的100例拟行子宫内膜息肉手术治疗的患者为研究对象,根据随机数表法将患者分为观察组和对照组各50例,对照组患者予传统宫腔镜下电切术,观察组患者采用宫腔镜刨削系统治疗,比较两组患者的手术情况(手术时间、术中出血量、膨宫液用量、月经恢复时间及并发症发生情况)、手术前后的雌二醇(E2)、黄体酮激素(LH)、孕酮(P)、血清卵泡雌激素(FSH)水平,同时比较两组患者术后1、2个月的息肉清除率。结果观察组患者的手术时间和月经恢复时间分别为(4.21±1.22)min、(20.02±6.31)d,明显短于对照组的(6.12±1.35)min、(26.31±5.76)d,术中出血量和膨宫液用量分别为(7.03±2.21)mL、(809.21±252.32)mL,明显少于对照组的(9.25±2.31)m L、(1505.31±363.53)m L,差异均有统计学意义(P<0.05);手术前,两组患者的生殖激素水平比较差异均无统计学意义(P>0.05),手术后,观察组患者的LH和FSH分别为(6.56±0.92)mIU/mL、(5.62±1.02)mIU/mL,明显高于对照组的(4.32±0.81)mIU/mL、(4.91±0.98)mIU/mL,差异均有统计学意义(P<0.05);观察组患者的术后并发症发生率为2.00%,明显低于对照组的16.00%,差异有统计学意义(P<0.05);手术后1个月、2个月,两组患者的息肉清除率比较差异均无统计学意义(P>0.05)。结论子宫内膜息肉患者应用宫腔镜刨削系统治疗,其手术时间和月经恢复时间较短,术后出血量较少,且并发症发生率更低,安全性更高。

Objective To analyze the clinical value of hysteroscopic morcellator system in the treatment of endometrial polyps.Methods A total of 100 patients with endometrial polyps who were treated by surgery in Department of Gynecology,Fuyong People’s Hospital of Bao’an District of Shenzhen from April 2019 to April 2020 were selected and divided into the control group and study group according to random number table method,with 50 patients in each group.The control group were treated with traditional hysteroscopic electrosurgical resection,while the study group were treated with hysteroscopic morcellator system.The operation conditions(operation time,intraoperative blood loss,amount of uterine distention fluid,menstrual recovery time and the incidence of complications),reproductive hormone levels[estradiol-1713(E2),luteinizing hormone(LH),progesterone(P),follicle stimulating hormone(FSH)]before and after operation were compared between the two groups.The incidence of complications such as intrauterine adhesions and uterine perforation.The polyp clearance rates were compared at 1 and 2 months after operation.Results The operation time and menstrual recovery time of the study group were(4.21±1.22)min,(20.02±6.31)d,respectively,which were significantly shorter than corresponding(6.12±1.35)min and(26.31±5.76)d of the control group;the amount of bleeding and the amount of distention fluid during the operation were(7.03±2.21)m L and(809.21±252.32)m L,respectively,which were significantly less than(9.25±2.31)m L,(1505.31±363.53)m L of the control group(P<0.05);before operation,there was no significant difference in reproductive hormone levels between the two groups(P>0.05);after the operation,the LH and FSH of the observation group were(6.56±0.92)m IU/m L and(5.62±1.02)m IU/m L,which were significantly higher than corresponding(4.32±0.81)m IU/m L and(4.91±0.98)m IU/m L of the control group(P<0.05);the complication rate of the observation group was 2.00%versus 16.00%of the control group(P<0.05);at 1 and 2 months after operation,there was no significant difference in the polyp clearance rate between the two groups(P>0.05).Conclusion Patients with endometrial polyps treated by hysteroscopic morcellator system have shorter recovery time of operation and menstruation,less postoperative bleeding,lower incidence of complications and higher safety.