门诊宫腔镜诊治子宫内膜息肉及宫颈息肉的临床价值

Clinical experience of hysteroscopy in the diagnosis and treatment of endometrial polyps and cervical polyps

目的探究门诊宫腔镜诊治子宫内膜息肉(EP)及宫颈息肉(CP)临床价值。方法选取2020年1月至12月本院收治的123例疑似EP患者、86例CP患者作为研究对象,患者均进行门诊宫腔镜及病理组织活检。其中84例患者接受门诊宫腔镜手术治疗,随机分为对照组与观察组,各42例。对照组行宫腔镜下刮宫术治疗,观察组行宫腔镜下电切术治疗,比较病理活检与门诊宫腔镜诊断准确率及两组手术指标。结果病理组织活检与宫腔镜对EP、CP的检出率比较差异无统计学意义。两组术中出血量、手术时间比较差异无统计学意义;随访1年,观察组复发率为2.38%,低于对照组的16.67%,差异有统计学意义(P<0.05)。结论门诊应用宫腔镜技术诊断EP、CP诊效果理想,且在宫腔镜下电凝术治疗,未明显增加手术用时及术中出血量,可降低术后1年复发率,值得临床推广应用。

Objective To explore the clinical value of outpatient hysteroscopy in the diagnosis and treatment of endometrial polyps(EP)and cervical polyps(CP).Methods A total of 123 suspected EP patients and 86 CP patients admitted to our hospital from January to December 2020 were selected as the study subjects,all patients underwent outpatient hysteroscopy and pathological biopsy.Among them,84 patients with polyps receiving outpatient treatment were randomly divided into control group and observation group,with 42 cases in each group.The control group was treated with hysteroscopic curettage,and the observation group was treated with hysteroscopic electrotomy,the diagnostic accuracy of pathological biopsy and outpatient hysteroscopy and the surgical indexes of the two groups were compared.Results There was no significant difference in the detection rate of EP and CP between biopsy and hysteroscopy.There was no significant difference in intraoperative blood loss and operation time between the two groups;after 1 year of follow-up,the recurrence rate in observation group was 2.38%,which was lower than 16.67%in control group,and the difference was statistically significant(P<0.05).Conclusions Hysteroscopy is ideal for the diagnosis of EP and CP in the outpatient department,and electrocoagulation under hysteroscopy does not significantly increase the operation time and intraoperative blood loss,and can significantly reduce the recurrence rate one year after surgery.Therefore,hysteroscopy is recommended for the treatment of EP or CP patients.