宫腔镜电切术在不同时间内治疗宫内妊娠物残留效果分析

Effect analysis of hysteroscopic resection on intrauterine pregnancy residue in different time

目的 探讨宫腔镜电切术在不同时间内治疗宫内妊娠物残留的效果。方法 选取90例人工流产后宫内妊娠组织残留妊娠期患者为研究对象,随机分为A组(2周≤人工流产术后<3周)、B组(3周≤人工流产术后<4周)、C组(4周≤人工流产术后<8周),每组30例。三组均再根据人绒毛膜促性腺激素(HCG)分为HCG较高组(血HCG>500 mIU/ml)与HCG较低组(血HCG<500 mIU/ml),观察三组患者的术中阴道出血量、血HCG下降至正常时间及宫内妊娠物残留情况,记录不同HCG分组下子宫内膜厚度和术后月经恢复时间。结果 术后,A组患者的阴道出血量、血HCG下降至正常时间最高,B组最低,差异有统计学意义(P<0.05);术后,HCG较高组的子宫内膜厚度薄于HCG较低组,同时术后月经恢复时间高于HCG较低组,差异有统计学意义(P<0.05);术后3周,C组的宫内组织残留为0%,均低于A组(20.00%)、B组(10.00%),差异有统计学意义(P<0.05)。结论 4周≤人工流产术后<8周内妊娠组织残留妊娠期患者行宫腔镜电切术的疗效最佳,并发症少,一次性治愈率高,可保护患者生育能力,具有临床意义。

Objective To explore the effect of hysteroscopic resection on intrauterine pregnancy residue in different time.Methods A total of 90 patients with residual pregnancy of intrauterine pregnancy tissue after induced abortion were selected as the study object,and they were randomly divided into group A(2 weeks≤after induced abortion<3 weeks),group B(3 weeks ≤after induced abortion<4 weeks),and group C(4 weeks≤after induced abortion<8 weeks),with 30 cases in each group.According to human chorionic gonadotropin(HCG),the three groups were divided into the high HCG group(blood HCG>500 mIU/ml)and the low HCG group(blood HCG<500 mIU/ml).The amount of vaginal bleeding during operation,the time when blood HCG drops to normal and the residue of intrauterine pregnancy in the three groups of patients were observed,and the endometrial thickness and menstrual recovery time after operation under different HCG groups were recorded.Results After operation,the amount of vaginal bleeding and blood HCG of patients in Group A decreased to the highest level in normal time,while that in Group B was the lowest,with statistically significant difference(P<0.05).After operation,the endometrial thickness of the higher HCG group was significantly thinner than that of the lower HCG group,and the menstrual recovery time after operation of the higher HCG group was significantly higher than that of the lower HCG group,the differences were statistically significant(P<0.05).Three weeks after operation,the intrauterine tissue residue in Group C was 0,which was lower than that in Group A(20.00%)and Group B(10.00%),with statistically significant difference(P<0.05).Conclusion Hysteroscopic electro surgical resection is the most effective method for patients with residual pregnancy tissue within 4 weeks≤after induced abortion<8 weeks,with less complications and high one-time cure rate.It can protect the fertility of patients and has clinical significance.