宫腔镜下冷刀切除术与电切术在子宫内膜息肉中的治疗效果对比

Comparison of hysteroscopic cold knife resection and electrotomy in the treatment of endometrial polyps

目的探讨子宫内膜息肉(EP)应用宫腔镜下冷刀切除术与电切术的治疗效果。方法选取150例子宫内膜息肉患者,根据随机数字表法分为对照组与研究组,每组75例。对照组行宫腔镜下电切术治疗,研究组行宫腔镜下冷刀切除术治疗,对比两组治疗效果。结果研究组手术时间及住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。术前,两组患者月经失血图(RBAC)评分与排卵期子宫内膜厚度比较,差异无统计学意义(P>0.05);术后3个月,研究组患者PBAC评分低于对照组,排卵期子宫内膜厚度厚于对照组,差异有统计学意义(P<0.05)。术前,两组患者搏动指数(PI)与阻力指数(RI)指标比较,差异无统计学意义(P>0.05);术后3个月,研究组患者RI、PI指标均显著低于对照组,差异有统计学意义(P<0.05)。随访1年后,研究组复发率6.67%低于对照组的17.33%,差异有统计学意义(P<0.05)。研究组宫内妊娠率高于对照组,异位妊娠率及流产率均低于对照组,差异有统计学意义(P<0.05)。结论宫腔镜下冷刀切除术手术操作时间短,出血量少,更有利于减少子宫内膜损伤,促进宫内妊娠,在子宫内膜息肉治疗中较宫腔镜下电切术更具优势。

Objective To investigate the therapeutic effect of hysteroscopic cold knife resection and electrotomy for endometrial polyps(EP).Methods 150 patients with endometrial polyps were selected and divided into control group and study group according to random number table method,75 cases in each group.The control group was treated with hysteroscopic electroresection,while the study group was treated with hysteroscopic cold knife resection.The therapeutic effects of the two groups were compared.Results The operation time and hospital stay of the study group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group,and the diff erences were statistically signifi cant(P<0.05).Before operation,there was no significant difference in menstrual blood loss map(RBAC)score and endometrial thickness during ovulation between the two groups(P>0.05).Three months after operation,the PBAC score of the study group was lower than that of the control group,and the endometrial thickness during ovulation was thicker than that of the control group,and the diff erences were statistically signifi cant(P<0.05).Before operation,there was no signifi cant diff erence in pulsatile index(PI)and resistance index(RI)between the two groups(P>0.05).At 3 months after operation,RI and PI indexes of the study group were signifi cantly lower than those of the control group,and the diff erences were statistically signifi cant(P<0.05).After 1 year follow-up,the recurrence rate of the study group was 6.67%lower than 17.33%of the control group,and the difference was statistically signifi cant(P<0.05).The intrauterine pregnancy rate in the study group was higher than that in the control group,and the ectopic pregnancy rate and abortion rate were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Hysteroscopic cold knife resection had short operation time and less bleeding,which was more conducive to reducing endometrial damage and promoting intrauterine pregnancy.It was more advantageous than hysteroscopic electrosurgery in the treatment of endometrial polyps.