宫腔镜组织切除系统与宫腔镜电切治疗宫腔病变的效果比较

Effect comparison of hysteroscopic tissue resection system and hysteroscopic electroresection in the treatment of uterine cavity lesions

目的比较宫腔镜组织切除系统及传统宫腔镜电切治疗宫腔病变患者的效果,旨在寻求更适合、更理想的治疗方案。方法选取2017年1月至2019年3月江西省妇幼保健院收治的250例有生育要求且已完成手术治疗的宫腔病变患者作为研究对象,按照手术方式的不同将其分为观察组(125例)和对照组(125例)。观察组患者使用宫腔镜组织切除系统进行手术,对照组患者使用传统宫腔镜电切进行手术。比较两组患者的手术效果,包括手术时间、术中出血量、术中膨宫液体使用量、手术疼痛程度;比较两组患者的并发症发生情况;比较两组患者的术后住院时间、术后恢复正常月经量占比、术后1年内再次妊娠率及手术一次成功率;比较两组的子宫内膜息肉、子宫黏膜下肌瘤复发率。结果观察组患者的手术时间短于对照组,术中出血量及术中膨宫液体使用量均少于对照组,差异有统计学意义(P<0.05);两组患者的语言评分法(VRS)评分、并发症总发生率比较,差异无统计学意义(P>0.05);两组患者的术后住院时间、术后恢复正常月经量占比及手术一次成功率比较,差异无统计学意义(P>0.05);观察组患者的术后1年内再次妊娠率高于对照组,差异有统计学意义(P<0.05);两组的子宫内膜息肉、子宫黏膜下肌瘤复发率比较,差异无统计学意义(P>0.05)。结论与传统宫腔镜电切术相比,宫腔镜组织切除系统进行手术可缩短宫腔病变患者的手术时间,减少手术出血量,可有效提高术后妊娠率,尤其适用于有生育要求的女性,值得在临床中推广应用。

Objective To compare the effect of hysteroscopic tissue resection system and traditional hysteroscopic electroresection in the treatment of patients with uterine cavity lesions,so as to seek a more suitable and ideal treatment plan.Methods From January 2017 to March 2019,250 patients with uterine cavity lesions who had fertility requirements and had completed surgical treatment in Jiangxi Provincial Maternal and Child Health Hospital were selected as the research objects.According to the different operation methods,they were divided into observation group(125 cases)and control group(125 cases).Patients in the observation group were operated with hysteroscopic resection system,while patients in the control group were operated with traditional hysteroscopic resection.The operation effect of the two groups was compared,including operation time,intraoperative blood loss,intraoperative dilated fluid usage,and surgical pain degree.The complications of the two groups were compared.The length of postoperative hospital stay,the proportion of postoperative normal menstrual volume,the rate of repregnancy within 1 year after operation and the success rate of one operation were compared between the two groups.The recurrence rates of endometrial polyps and submucosal myoma were compared between the two groups.Results The operation time of the observation group was shorter than that of the control group,the amount of intraoperative blood loss and the amount of intraoperative dilated fluid were less than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the verbal rating scale(VRS)score and the total incidence of complications between the two groups(P>0.05).There were no significant differences in the postoperative hospital stay,the proportion of postoperative normal menstrual volume and the success rate of the first operation between the two groups(P>0.05).The rate of repregnancy within 1 year after operation in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the recurrence rates of endometrial polyps and submucosal myomas between the two groups(P>0.05).Conclusion Compared with traditional hysteroscopic electroresection,hysteroscopic tissue resection system can shorten the operation time of patients with uterine cavity lesions,reduce the amount of surgical bleeding,and effectively improve the postoperative pregnancy rate,especially for women with fertility requirements,which is worthy of clinical application.