宫腔镜7Fr冷刀在绝经后子宫内膜息肉中的临床应用价值

Clinical Value of Hysteroscopic 7Fr Cold Knife in Postmenopausal Endometrial Polyp

目的:探讨宫腔镜7Fr冷刀在绝经后子宫内膜息肉中的诊断和治疗价值。方法:将2020年3月1日至2022年6月1日湖北省妇幼保健院收治的185例绝经后子宫内膜增生患者分为息肉组(165例)和非息肉组(20例),比较两组患者的临床特点和超声影像学特点。再根据治疗方式将165例息肉组患者分为诊刮组、冷刀组和电刀组,比较3组患者在治疗上耗费的时间、住院总费用和手术效果。结果:(1)子宫内膜息肉在绝经后内膜增生患者中占比为89.19%,内膜恶变患者占比为1.08%。(2)将息肉组和非息肉组患者的临床特征进行比较,患者绝经年数的差异有统计学意义(χ^(2)=-2.27,P<0.05),其他特征比较差异无统计学意义(P>0.05)。(3)宫腔镜诊断绝经后子宫内膜息肉的诊断准确性(敏感度92.70%,特异度70.00%)明显优于超声诊断(敏感度63.60%,特异度45.00%)。(4)宫腔镜7Fr冷刀组患者用对于绝经后子宫内膜息肉的完全切除率达到100%,术中及术后并发症为0,治疗总费用适中。结论:宫腔镜7Fr冷刀对于绝经后的子宫内膜息肉可以完成诊疗同步,且对扩张子宫颈的要求相对较低,从而降低了手术难度和风险,医疗总费用也相对适中,值得在临床上推广使用。

Objective:To investigate the value of hysteroscopy 7Fr cold knife in the diagnosis and treatment of postmenopausal endometrial polyps.Methods:A total of 185 postmenopausal patients with endometrial hyperplasia admitted to Hubei Maternal and Child Health Hospital from March 1,2020 to June 1,2022 were divided into a polyp group(165 cases)and a non-polyp group(20 cases).The clinical characteristics and ultrasound imaging characteristics of the two groups were compared.According to the treatment methods, 165 patients in the polyp group were divided into three groups: curettage group, cold knife group and electric knife group.The time spent on treatment, total hospitalization cost and operation effect were compared among the three groups.Results:(1)The proportion of endometrial polyps in postmenopausal patients with endometrial hyperplasia was 89.19%,and the proportion of endometrial malignant transformation was 1.08%.(2)The clinical characteristics of the polyp group and the non-polyp group were compared, and the difference of menopausal years was statistically significant(χ^(2)=-2.27,P<0.05),but there was no significant difference in other characteristics(P>0.05).(3)The diagnostic accuracy of hysteroscopy in the diagnosis of postmenopausal endometrial polyps(sensitivity 92.70%,specificity 70.00%)was significantly better than that of ultrasound(sensitivity 63.60%,specificity 45.00%).(4)In the hysteroscopic 7Fr cold surgery group, the complete resection rate of postmenopausal endometrial polyps reached 100%,the incidence of intraoperative and postoperative complications was 0%,and the total cost of treatment was moderate.Conclusion:7Fr hysteroscopic cold knife for postmenopausal endometrial polyps can complete the diagnosis and treatment of synchronization, and the requirements for cervical dilatation are relatively low, so as to reduce the difficulty and risk of surgery, and the total medical cost is relatively moderate, which is worthy of clinical application.Abstracts please extract the content of the text, the method of grouping, please concise results, the format of the abstract to the text.