宫腔镜冷刀切除术对育龄期多发子宫肌瘤患者性激素及妊娠结局的影响

Effects of hysteroscopic cold-knife resection on sex hormones and pregnancy outcomes in patients with multiple uterine fibroids of childbearing age

目的分析育龄期多发子宫肌瘤患者采用宫腔镜冷刀切除术治疗对其性激素、妊娠结局的影响。方法110例育龄期多发子宫肌瘤患者,按随机数字表法分为对照组及研究组,每组55例。对照组患者给予传统的宫腔镜电切术治疗,研究组患者给予宫腔镜冷刀切除术治疗。比较两组手术指标(术中出血量、手术时间、术后排气时间、住院时间),治疗前后的性激素指标[雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)],并发症发生情况,治疗后18个月的妊娠情况。结果研究组患者的术中出血量(50.01±2.79)ml少于对照组的(116.48±8.12)ml,手术时间(51.27±4.39)min、术后排气时间(33.24±4.01)h、住院时间(7.06±1.02)d短于对照组的(72.09±6.56)min、(45.32±5.43)h、(14.28±2.46)d,差异具有统计学意义(P<0.05)。治疗后,两组E2低于本组治疗前,FSH、LH高于本组治疗前,且研究组患者E2(72.76±5.69)ng/L低于对照组的(76.01±5.12)ng/L,FSH(7.83±0.77)IU/L、LH(9.83±1.14)IU/L高于对照组的(7.13±0.92)、(9.08±1.17)IU/L,差异具有统计学意义(P<0.05)。治疗后,研究组患者并发症发生率5.45%低于对照组的18.18%,差异具有统计学意义(P<0.05)。治疗后18个月,研究组患者的妊娠率96.36%(53/55)高于对照组的81.82%(45/55),差异具有统计学意义(P<0.05)。结论育龄期多发子宫肌瘤患者采用宫腔镜冷刀切除术治疗的效果较好,可改善患者的性激素指标、妊娠结局,有一定临床应用与研究价值。

Objective To analyze the effects of hysteroscopic cold-knife resection on sex hormones and pregnancy outcomes in patients with multiple uterine fibroids of childbearing age.Methods A total of 110 patients with multiple uterine fibroids of childbearing age were divided into control group and study group according to random numerical table,with 55 cases in each group.The control group was treated with conventional hysteroscopic electrotomy,and the study group was treated with hysteroscopic cold knife resection.Both groups were compared in terms of surgical indexes(intraoperative blood loss,operative time,postoperative exhaust time,hospitalization time),sex hormone indexes[estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH)]before and after treatment,occurrence of complications,and the pregnancy status at 18 months after treatment.Results The intraoperative blood loss of(50.01±2.79)ml in the study group was less than that of(116.48±8.12)ml in the control group;the study group had operative time of(51.27±4.39)min,postoperative exhaust time of(33.24±4.01)h and hospitalization time of(7.06±1.02)d,which were shorter than those of(72.09±6.56)min,(45.32±5.43)h and(14.28±2.46)d in the control group;the difference were statistically significant(P<0.05).After treatment,E2 in both groups was lower than that before treatment in this group,and FSH and LH were higher than those before treatment in this group;E2 of(72.76±5.69)ng/L in the study group was lower than that of(76.01±5.12)ng/L in the control group;FSH of(7.83±0.77)IU/L and LH of(9.83±1.14)IU/L in the study group were higher than those of(7.13±0.92)and(9.08±1.17)IU/L in the control group;the difference were statistically significant(P<0.05).After treatment,the complication rate of 5.45%in the study group was lower than that of 18.18%in the control group,and the difference was statistically significant(P<0.05).At 18 months after treatment,the pregnancy rate in the study group was 96.36%(53/55),which was higher than that of 81.82%(45/55)in the control group,and the difference was statistically significant(P<0.05).Conclusion Hysteroscopic cold-knife resection has good effect on patients with multiple uterine fibroids of childbearing age,which can improve the sex hormone index and pregnancy outcome of patients,and has certain clinical application and research value.