宫腔镜手术在异常子宫出血患者中的应用效果观察

Clinical observation of hysteroscopic surgery in patients with abnormal uterine bleeding

目的探讨宫腔镜手术在异常子宫出血患者中的应用效果。方法48例异常子宫出血患者,采用随机数字表法分为对照组和观察组,每组24例。对照组采用诊断性刮宫治疗,观察组采用宫腔镜手术治疗。比较两组手术指标,手术前后生活质量评分,手术前后血红蛋白及子宫内膜厚度,并发症发生情况。结果两组凝血块时间比较差异无统计学意义(P>0.05);观察组手术时间(22.52±3.59)min、住院时间(2.19±0.42)d均短于对照组的(33.19±4.73)min、(4.74±0.71)d,术中出血量(38.73±5.39)ml少于对照组的(61.29±6.89)ml,差异具有统计学意义(P<0.05)。手术前,两组生理领域、社会关系、心理领域、主观生活质量、环境领域及主观健康评分比较差异无统计学意义(P>0.05);手术7 d后,两组生理领域、社会关系、心理领域、主观生活质量、环境领域及主观健康评分均高于手术前,观察组生理领域评分(27.56±4.53)分、社会关系评分(46.72±6.42)分、心理领域评分(3.96±0.56)分、主观生活质量评分(4.32±0.59)分、环境领域评分(26.33±4.74)分及主观健康评分(4.43±0.62)分均高于对照组的(20.41±3.29)、(40.21±4.98)、(2.35±0.54)、(3.31±0.48)、(20.63±3.46)、(3.32±0.43)分,差异具有统计学意义(P<0.05)。手术前,两组血红蛋白和子宫内膜厚度比较差异无统计学意义(P>0.05);手术7 d后,两组血红蛋白与子宫内膜厚度均较手术前改善,观察组血红蛋白(96.35±7.32)g/L高于对照组的(85.28±6.18)g/L,子宫内膜厚度(5.12±0.42)mm小于对照组的(7.39±0.56)mm,差异具有统计学意义(P<0.05)。两组治疗过程中并发症发生率比较差异无统计学意义(P>0.05)。结论宫腔镜手术用于异常子宫出血患者中,创伤较轻,能提升患者生活质量,有助于改善血红蛋白和子宫内膜厚度,且手术安全性较高,值得推广应用。

Objective To discuss the application effect of hysteroscopic surgery in patients with abnormal uterine bleeding.Methods A total of 48 patients with abnormal uterine bleeding were randomly divided into control group and observation group,with 24 cases in each group.The control group was treated with diagnostic curettage,and the observation group was treated with hysteroscopic surgery.Both groups were compared in terms of surgical indexes,quality of life score before and after surgery,hemoglobin and endometrial thickness before and after surgery,and the occurrence of complications.Results There was no statistically significant difference in clotting time between the two groups(P>0.05).The operative time of(22.52±3.59)min and hospital stay of(2.19±0.42)d in the observation group were shorter than those of(33.19±4.73)min and(4.74±0.71)d in the control group;the intraoperative blood loss of(38.73±5.39)ml in the observation group was less than that of(61.29±6.89)ml in the control group;the differences were statistically significant(P<0.05).Before surgery,there were no statistically significant differences in physiological field,social relationship,psychological field,subjective quality of life,environmental field and subjective health score between the two groups(P>0.05).After 7 d of surgery,the physiological domain,social relationship,psychological domain,subjective quality of life,environmental domain and subjective health scores in both groups were higher than those before surgery in this group;the observation group had physiological domain score of(27.56±4.53)points,social relationship score of(46.72±6.42)points,psychological domain score of(3.96±0.56)points,subjective quality of life score of(4.32±0.59)points,environmental domain score of(26.33±4.74)points,and subjective health score of(4.43±0.62)points,which were higher than those of(20.41±3.29),(40.21±4.98),(2.35±0.54),(3.31±0.48),(20.63±3.46),and(3.32±0.43)points in the control group;the differences were statistically significant(P<0.05).Before surgery,there were no statistically significant differences in hemoglobin and endometrial thickness between the two groups(P>0.05).After 7 d of surgery,the hemoglobin and endometrial thickness in both groups were improved compared with those before surgery;the hemoglobin of(96.35±7.32)g/L in the observation group was higher than that of(85.28±6.18)g/L in the control group;the endometrial thickness of(5.12±0.42)mm in the observation group was lower than that of(7.39±0.56)mm in the control group;the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Hysteroscopic surgery in patients with abnormal uterine bleeding is less invasive,and can enhance the quality of life of patients,help improve the hemoglobin and endometrial thickness,and has a high surgical safety,which is worthy of promotion and application.