比较宫腔镜子宫内膜电切除术、腹腔镜保留双侧卵巢子宫全切除术应用于功能失调性子宫出血治疗价值

To Compare the Value of Hysteroscopic Endometrial Electrotomy and Laparoscopic Sparing Bilateral Total Ovary Hysterectomy in the Treatment of Dysfunctional Uterine Bleeding

目的:分析对于功能失调性子宫出血患者采用宫腔镜下子宫内膜电切术或者腹腔镜下保留双侧卵巢子宫全切术的治疗价值。方法:抽取2019年1月~2021年3月三级医院76例功能失调性子宫出血患者,采用随机数字表法分组,观察组行宫腔镜下子宫内膜电切除术治疗,对照组采用腹腔镜辅助下保留双侧卵巢子宫切除术进行治疗,对比两组的术后康复进程指标、血红蛋白水平、术后不良反应发生率和手术前后的性激素指标变化。结果:观察组术后的排气时间、卧床时间和住院天数均短于对照组,P<0.05;术前两组的E2、LH、FSH、P水平对比,P>0.05,术后3个月观察组E2、P高于对照组,LH、FSH低于对照组,P<0.05;术前两组的Hb水平组对比,P>0.05,术后6个月观察组Hb水平组高于对照组,P<0.05;观察组术后不良反应发生率为2.63%,对照组为15.79%,P<0.05。结论:对于功能失调性子宫出血患者应用宫腔镜子宫内膜电切术更有利于降低创伤性、加快术后康复进程,并可减少对患者卵巢功能的影响。

Objective:To analyze the therapeutic value of hysteroscopic endometrial electrotomy or laparoscopic bilateral ovary spreservation hysterectomy in patients with dysfunctional uterine bleeding.Methods:Seventy-six patients with dysfunctional uterine bleeding from January 2019 to March 2021 in a level-Ⅲ hospital were selected and randomly divided into groups by number table method.The observation group was treated with hysteroscopic endometrial electrotomy,while the control group was treated with laparoscopic bilateral spare-ovary hysterectomy.The postoperative recovery progress indexes,hemoglobin level,postoperative adverse reaction rate and sex hormone indexes before and after operation were compared between the two groups.Results:The postoperative exhaust time,bed rest time and hospitalization days in the observation group were shorter than those in the control group,P<0.05;The comparison of E2,LH,FSH and P levels between the two groups before surgery was P>0.05,and 3 months after surgery,E2 and P in the observation group were higher than those in the control group,and LH and FSH were lower than those in the control group,P<0.05;The Hb level of the two groups before operation was compared P>0.05,and the Hb level of the observation group was higher than that of the control group at 6 months after operation,P<0.05;The postoperative adverse reaction rate was 2.63%in the observation group and 15.79%in the control group,P<0.05.Conclusion:For patients with dysfunctional uterine bleeding,hysteroscopic endometrial electrotomy is more beneficial to reduce the trauma,accelerate the process of postoperative rehabilitation,and reduce the impact on the ovarian function of patients.