宫腔镜下行电切术结合刮宫术对多发性子宫内膜息肉患者临床效果及免疫功能的影响

The Effect of Hysteroscopic Resection Combined with Curettage on the Clinical Effect and Immune Function of Patients with Multiple Endometrial Polyps

目的探究宫腔镜下行电切术+刮宫术治疗对多发性子宫内膜息肉(endometrial polyps,EMP)患者临床效果及免疫功能的影响。方法方便选择禹城市人民医院2019年6月—2020年10月收治的146例多发性EMP患者为研究对象,按随机数表法分为对照组(73例)和观察组(73例)。对照组给予宫腔镜电切术治疗,观察组结合刮宫术,术后随访1年。比较两组治疗效果、手术相关指标、子宫内膜厚度、月经量、免疫功能、血管内皮生长因子(VEGF)水平及复发率。结果观察组治疗总有效率为97.26%,高于对照组的86.30%,差异有统计学意义(χ^(2)=5.811,P<0.05);观察组术后3个月子宫内膜厚度、PBAC评分[(5.46±1.13)mm、(74.83±10.10)分]均低于对照组,差异有统计学意义(t=12.776、18.112,P<0.05),术后1周免疫球蛋白(IgA、IgG)水平[(1.40±0.25)g/L、(9.86±0.53)g/L]均高于对照组,术后3个月VEGF水平[(30.66±5.54)ng/L]低于对照组,差异有统计学意义(t=8.540、18.347、6.337,P<0.05);观察组EMP、异常子宫出血复发率分别为1.37%、2.74%,均低于对照组的10.96%、12.33%,差异有统计学意义(χ^(2)=4.263、4.818,P<0.05)。结论宫腔镜下行电切术+刮宫术治疗多发性EMP效果更佳,能够减少子宫内膜厚度,改善月经量及VEGF水平,降低疾病复发风险,且对患者免疫功能影响小。

Objective To explore the effect of hysteroscopic resection + curettage on the clinical effect and immune function of patients with multiple endometrial polyps(EMP). Methods A total of 146 patients with multiple EMP who were admitted to Yucheng People’s Hospital from June 2019 to October 2020 were conveniently selected and as the study objects divided into the control group(73 cases) and the observation group(73 cases) according to the random number table method. The control group was given hysteroscopic electrosurgery, and the observation group was combined with curettage and curettage. The patients were followed up for 1 year. The treatment effect, surgery-related indicators, endometrial thickness, menstrual flow, immune function, vascular endothelial growth factor(VEGF) level and recurrence rate were compared between the two groups. Results The total effective rate of treatment in the observation group was 97.26%, which was higher than that in the control group(86.30%), and the difference was statistically significant(χ^(2)=5.811, P<0.05).The endometrial thickness and PBAC score [(5.46±1.13) mm,(74.83±10.10) points] in the observation group were lower than those in the control group at 3 months after operation, and the difference was statistically significant(t=12.776, 18.112, P<0.05). The levels of immunoglobulin(IgA, IgG) 1 week after operation [(1.40±0.25) g/L,(9.86±0.53) g/L] were higher than those of the control group, and the VEGF level [(30.66±5.54) ng/L] three months after surgery was lower than that of the control group, the difference was statistically significant(t=8.540,18.347, 6.337, P<0.05);the recurrence rates of EMP and abnormal uterine bleeding in the observation group were 1.37% and 2.74%, respectively, which were lower than those in the control group(10.96%, 12.33%), and the difference was statistically significant(χ^(2)=4.263, 4.818, P<0.05). Conclusion Hysteroscopic resection + curettage is more effective in the treatment of multiple EMP, which can reduce endometrial thickness, improve menstrual flow and VEGF level, and reduce the risk of disease recurrence. Moreover, it has little impact on the immune function of patients.