宫腔镜手术治疗子宫内膜息肉不孕症患者的临床观察

Clinical Observation of Hysteroscopic Surgery for Infertility Patients with Endometrial Polyp

目的探讨子宫内膜息肉(EP)不孕症患者采用宫腔镜手术治疗的临床效果。方法回顾性分析2019年2月至2021年9月在三门峡渑池县人民医院收治的62例子宫内膜息肉不孕症患者的临床资料,所有患者均采用宫腔镜手术方式治疗,其中给予宫腔镜下子宫内膜息肉刮宫术治疗的31例患者纳入研究1组,其余31例给予宫腔镜下子宫内膜息肉电切术治疗的患者纳入研究组,两组术后均开展为期1年的随访,比较治疗前后月经情况、血红蛋白量的变化,观察两组患者手术相关指标间的差异,评价两组宫腔镜手术治疗方式的有效性和安全性。结果两组手术时长对比差异无统计学意义(P>0.05);但研究2组术中失血量少于研究1组,术后住院天数短于研究1组,差异有统计学意义(P<0.05)。两组手术前月经量和血红蛋白量比较差异无统计学意义(P>0.05);术后3个月和6个月,两组月经量较本组手术前相比明显降低,血红蛋白量较本组手术前相比明显提高,组内对比,差异有统计学意义(P<0.05);并且研究2组术后3个月和6个月月经量水平均低于研究1组,血红蛋白量水平高于研究1组,组间对比,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。研究2组复发率3.23%低于研究1组29.03%,妊娠率70.97%高于研究1组45.16%,差异有统计学意义(P<0.05)。结论宫腔镜手术治疗子宫内膜息肉不孕症患者的疗效确切,但与宫腔镜下刮宫术相比,宫腔镜下电切术更有利于减少对患者造成的损伤,改善患者术后月经情况,降低子宫内膜息肉复发率的同时促进患者早日康复,提高患者的妊娠率,临床治疗安全性和有效性更高,值得应用。

Objective To investigate the clinical effect of hysteroscopic surgery on infertility patients with endometrial polyp(EP).Methods Clinical data of 62 infertile patients with endometrial polyp treated in Sanmenxia Miachi County People's Hospital from February 2019 to September 2021 were retrospectively analyzed.All patients were treated by hysteroscopic surgery,and 31 patients treated by hysteroscopic curettage of endometrial polyp were included in the study 1group,the remaining 31 patients who received hysteroscopic electroresection of endometrial polyps were included in the study 2 group,and both groups were followed up for 1 year.The changes of menstrual conditions and hemoglobin levels before and after treatment were compared,and the differences of surgical indicators between the two groups were observed to evaluate the effectiveness and safety of hysteroscopic surgical treatment.Results There was no significant difference in operation duration between the two groups(P>0.05).However,the intraoperative blood loss in study 2 group was less than that in study 1 group,and the postoperative hospitalization days were shorter than that in study 1 group,with statistical significance(P<0.05).There were no significant differences in menstrual volume and hemoglobin before operation between the two groups(P>0.05).At 3 and 6 months after surgery,menstrual volume in the two groups was significantly lower than that before surgery,and hemoglobin level was significantly higher than that before surgery,with statistically significant differences within the group(P<0.05).The menstrual volume level of 3 and 6 months after surgery in study 2 group was lower than that in study 1 group,and the hemoglobin level was higher than that in study 1 group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The recurrence rate of study 2 group(3.23%)was lower than that of study 1 group(29.03%),and the pregnancy rate of study 2 group(70.97%)was higher than that of study 1 group(45.16%),with statistical significance(P<0.05).Conclusion The curative effect of hysteroscopic surgery on infertility patients with endometrial polyp is definite.But compared with curettage under hysteroscopy surgery,hysteroscopic electric resection is more advantageous to reduce the damage to the patients,improve patients with postoperative period,reduce the endometrial polyp recurrence rate,at the same time,promote the patient recover at an early date,improve the patient's pregnancy rate,clinical safety and efficacy is higher,which is worthy of application.