宫腔镜下钳夹术与宫腔镜下电切术在息肉数目≥3个子宫内膜息肉患者中的应用

Application of Clamp Operation under Hysteroscopic and Electrotomy under Hysteroscopic in Endometrial Polyp Patients with Number of Polyps≥3

目的:比较宫腔镜下钳夹术与宫腔镜下电切术在息肉数目≥3个子宫内膜息肉(EP)患者中的应用。方法:选取2019年1月-2021年1月龙岩市第二医院收治的息肉数目≥3个的EP患者168例作为研究对象。根据随机数字表法将其分为对照组和治疗组,各84例。对照组给予宫腔镜下钳夹术。治疗组给予宫腔镜下电切术。比较两组围手术期指标,术前,术后6、12个月月经量、子宫内膜厚度,并发症及术后3、6、12个月复发率。结果:治疗组手术时间短于对照组,术中出血量少于对照组(P<0.05)。治疗组术后6、12个月月经失血图(PBAC)评分、子宫内膜厚度均低于对照组(P<0.05)。治疗组并发症发生率1.19%(1/84)低于对照组的4.76%(4/84),但差异无统计学意义(P>0.05)。两组术后3个月均没有复发例数。两组术后6个月复发率比较差异无统计学意义(P>0.05);术后12个月,治疗组复发率为2.38%(2/84),低于对照组的16.67%(14/84)(P<0.05)。结论:相较于宫腔镜下钳夹术,宫腔镜下电切术用于息肉数目≥3个EP患者中可取得更好的效果,有利于缩短手术时间,降低复发率,减少出血量,并改善月经量。

Objective:To compare the application of clamp operation under hysteroscopic and electrotomy under hysteroscopic in endometrial polyp(EP)patients with number of polyps≥3.Method:From January 2019 to January 2021,168 EP patients with number of polyps≥3 admitted to the Second Hospital of Longyan City were selected as the study subjects.According to the method of random number table,they were divided into control group and treatment group,84 cases in each group.The control group was given the clamp operation under hysteroscopic.The treatment group was given electrotomy under hysteroscopic.Perioperative indexes,menstrual volume,endometrial thickness before operation,6 and 12 months after operation,complications and recurrence rate at 3,6 and 12 months after operation were compared between the two groups.Result:The operation time of the treatment group was shorter than that of the control group,and the amount of intraoperative bleeding was less than that of the control group(P<0.05).The pictorial blood loss assessment chart(PBAC)score and endometrial thickness in the treatment group were lower than those in the control group at 6 and 12 months after operation(P<0.05).The incidence of complications in the treatment group was 1.19%(1/84),which was lower than 4.76%(4/84)in the control group,but the difference was not statistically significant(P>0.05).There were no recurrence cases in both groups 3 months after operation.There was no significant difference between the two groups in the recurrence rate at 6 months after operation(P>0.05);12 months after operation,the recurrence rate in the treatment group was 2.38%(2/84),which was lower than 16.67%(14/84)in the control group(P<0.05).Conclusion:Compared with the clamp operation under hysteroscopic,electrotomy under hysteroscopic can achieve better effect in EP patients with the number of polyps≥3,which is conducive to shortening the operation time,reducing the recurrence rate,reducing the amount of bleeding,and improving the amount of menstruation.