宫腔镜宫内刨削系统治疗难治性宫内残留的临床效果评价

Clinical evaluation of the treatment of refractory intrauterine residues by hysteroscopic intrauterine planing system

目的研究宫腔镜宫内刨削系统治疗难治性宫内残留的临床效果。方法选取2020年4月至2022年3月安徽省妇幼保健院收治的82例难治性宫内妊娠组织残留患者为研究对象,根据手术方法将其分为刨削组和电切组,各41例;刨削组予以宫腔镜下刨削术治疗,电切组予以宫腔镜下电切术治疗。记录并比较两组患者术后治愈率、手术时间、术中出血量、术后苏醒时间、术后阴道出血时间、术后月经恢复正常时间、术后月经量、术后血绒毛膜促性腺激素(HCG)恢复正常时间、排卵期子宫内膜厚度,并比较两组术后4周内并发症发生率。结果两组患者术后治愈率差异无统计学意义(χ^(2)=0.263,P>0.05);刨削组手术时间、术后阴道出血时间、术后月经恢复正常时间及术后HCG恢复正常时间均短于电切组(t值分别为4.614、4.725、2.931、2.884,P<0.05);刨削组术中出血量、术后月经量均低于电切组(t值分别为6.649、11.789,P<0.05),排卵期子宫内膜厚度高于电切组(t=5.851,P<0.05);刨削组术后并发症发生率低于电切组(χ^(2)=5.145,P<0.05)。结论宫腔镜宫内刨削系统治疗难治性宫内残留疗效优于电切术,有助于降低患者术后并发症发生率,有利于保护生育力。

Objective To explore the clinical effect of hysteroscopic intrauterine planing system on the treatment of refractory intrauterine residues.Methods A total of 82 patients with refractory intrauterine pregnancy tissue residues treated in Anhui Province Maternity and Child Health Hospital from April 2020 to March 2022 were selected as the research objects.According to the surgical methods,they were divided into the planing group and the electrotomy group,with 41 cases in each group.The planing group was treated with hysteroscopic planing system,and the electrotomy group was treated with hysteroscopic electrotomy.The postoperative cure rate,operation time,intraoperative bleeding volume,postoperative recovery time,postoperative vaginal bleeding time,postoperative menstrual recovery time,postoperative menstrual volume,postoperative human chorionic gonadotropin(HCG)recovery time,endometrial thickness during ovulation were recorded and compared between the two groups,and the incidence of complications within 4 weeks after operation was compared between the two groups.Results There was no significant difference in the postoperative cure rate between the two groups(χ^(2)=0.263,P>0.05).The operation time,postoperative vaginal bleeding time,postoperative menstrual recovery time and the recovery time of HCG in the planing group were shorter than those in the electrotomy group(t=4.614,4.725,2.931 and 2.884,respectively,P<0.05).The intraoperative bleeding volume and postoperative menstrual volume in the planing group were lower than those in the electrotomy group(χ^(2)=6.649 and 11.789,respectively,P<0.05),and the thickness of endometrium during ovulation was higher than that in the electrotomy group(t=5.851,P<0.05).The incidence of postoperative complications in the planing group was lower than that in the electrotomy group(χ^(2)=5.145,P<0.05).Conclusion Hysteroscopic intrauterine planing system is more effective in the treatment of refractory intrauterine residues than electrotomy,which helps to reduce the incidence of postoperative complications and protect fertility.