宫腔镜息肉切除联合多西环素治疗慢性子宫内膜炎合并子宫内膜息肉效果及对妊娠结局影响

Efficacy of hysteroscopic polypectomy combined with doxycycline for treating patients with chronic endometritis and endometrial polyp and it influence on the pregnancy outcomes of these patient

目的:探究宫腔镜息肉切除术联合多西环素治疗慢性子宫内膜炎合并子宫内膜息肉疗效与对妊娠的影响。方法:回顾性收集2019年1月—2021年1月本院就诊行宫腔镜术息肉切除术的88例慢性子宫内膜炎合并子宫内膜息肉患者临床资料,根据宫腔镜息肉摘除术后是否服用多西环素治疗分为治疗组(40例)和非治疗组(48例)。比较两组治疗后宫内细菌培养菌群分布、子宫内膜炎治愈率和膜硫酸乙酰肝素蛋白多糖配体蛋白聚糖-1(CD138)阳性浆细胞计数;统计子宫内膜炎治愈时间,术后并发症和息肉复发情况,慢性子宫内膜炎治愈后6个月内妊娠结局。结果:非治疗组CD138阳性细胞(2.1±3.7)、慢性子宫内膜炎治愈率(89.6%)与治疗组(3.2±3.2、75.0%)无差异(P>0.05),术后子宫内膜炎恢复时间(42.3±5.2d)少于治疗组(56.5±32.3d)(P<0.05),乳酸菌检出率、术后并发症发生及子宫内膜息肉复发率治疗组(10.0%)与非治疗组(6.25%)均无差异(均P>0.05)。两组术后均有35例妊娠,妊娠方式及妊娠后流产发生率两组无差异(P>0.05),非治疗组临床妊娠率(74.3%)高于治疗组(34.3%)、备孕至妊娠时间(80.5±55.7d)少于治疗组(120.6±68.6d)(P<0.05)。结论:慢性子宫内膜炎合并子宫内膜息肉息肉切除术治疗效果较好,而术后联合多西环素治疗会延迟术后恢复,降低了术后妊娠率并延长妊娠时间。

Objective:To explore the efficacy of hysteroscopic polypectomy combined with doxycycline for treating patients with chronic endometritis and endometrial polyp,and to study it influences on the pregnancy outcomes of these patients.Methods:The clinical data of 88patients with chronic endometritis and endometrial polyp from January 2019 to January 2021were collected.These patients were divided into study group(40patients with doxycycline treatment)and control group(48patients without doxycycline treatment)based on their treatment with doxycycline after hysteroscopic polyp removal.The distribution of intrauterine bacterial culture,the cure rate of endometritis,and the positive plasma cell count of membrane heparan sulfate proteoglycan ligand proteoglycan-1(CD138)of the patients were compared between the two groups.The time of endometritis cure,the postoperative complications rate,the polyp recurrence situation,and the pregnancy outcomes within 6months after chronic endometritis cure of the patients were counted.Results:The CD138positive cells count(2.1±3.7)and the cure rate of chronic endometritis(89.6%)of the patients in the control group had no significantly different from those(3.2±3.2and 75.0%)of the patients in the study group(P>0.05).The time of postoperative endometritis recovery(42.3±5.2d)of the patients in the control group was significantly less than that(56.5±32.3d)of the patients in the study group(P<0.05).There were no significant differences in the detection rate of lactic acid bacteria and the postoperative complications rate of the patients between the two groups.The rate of endometrial polyps recurrence(10.0%)of the patients in the study group had no significantly different from that(6.3%)of the patients in the control group(all P>0.05).There were 35patients with postoperative pregnancy in both groups,and there were no significant differences in the mode of delivery and the incidence of post-pregnancy abortion of the patients between the two groups(P>0.05).The clinical pregnancy rate(74.3%)of the patients in the control group was significantly higher than that(34.3%)of the patients in the study group,and the time from pregnancy preparation to pregnancy(80.5±55.7d)of the patients in the control group was significantly lower than that(120.6±68.6d)of the patients in the study group(P<0.05).Conclusion:The polyp resection for treating the patients with chronic endometritis and endometrial polyps has better cured efficacy,but which combined with the postoperative treatment of doxycycline can delay the postoperative recovery,decrease the postoperative pregnancy rate,and delay the postoperative pregnancy.