宫腔镜下冷刀切除术对子宫内膜息肉患者围术期指标及术后恢复的影响

Effect of Hysteroscopic Cold Knife Resection on Perioperative Indicators and Postoperative Recovery in Patients with Endometrial Polyps

目的:探讨宫腔镜下冷刀切除术对子宫内膜息肉(EP)患者围术期指标及术后恢复的影响。方法:选取2021年3月—2022年3月桐柏第三医院收治的102例EP患者作为研究对象,采用随机数表法分为对照组和观察组,每组各51例。观察组患者采用宫腔镜下冷刀切除术治疗,对照组患者予以宫腔镜下电切术治疗。比较两组患者围术期指标、术后恢复、子宫内膜血流参数、月经量、排卵期子宫内膜厚度、血清转化生长因子-β1(TGF-β1)、纤溶酶原激活剂抑制因子-1(PAI-1)水平。结果:观察组患者术中出血量少于对照组,手术、阴道流血的时间短于对照组,手术切净率高于对照组,阴道出血量、宫腔粘连率、红细胞聚集率低于对照组,差异有统计学意义(t=3.085、4.037、9.321;χ^(2)=4.427、6.793、4.387、7.256,P<0.05);术后3个月,观察组患者子宫内膜血流搏动指数(PI)、阻力指数(RI)、月经失血图(PBAC)评分均低于对照组,排卵期子宫内膜厚度高于对照组,血清TGF-β1、PAI-1水平低于对照组,差异有统计学意义(t=2.934、2.860、3.947、2.753、5.311、4.254,P<0.05)。结论:宫腔镜下冷刀切除术对EP患者围术期指标及术后恢复的改善具有积极意义,且有利于调节患者子宫内膜血流、厚度,减少月经量,改善TGF-β1、PAI-1水平。

Objective:To investigate the effect of hysteroscopic cold knife resection on perioperative indicators and postoperative recovery in patients with endometrial polyps(EP).Methods:102 EP patients from Tongbai Third Hospital from March 2021 to March 2022 were selected as the study subjects.They were randomly divided into control group and observation group,with 51 patients in each group.The observation group was treated with hysteroscopic cold knife resection,while the control group was treated with hysteroscopic electric resection.Perioperative indicators and postoperative recovery,endometrial blood flow parameters,menstrual volume,ovulation endometrial thickness,and serum transforming growth factor-β1(TGF-β1)Plasminogen activator inhibitor-1(PAI-1)level between the two groups were compared.Results:The results showed that the intraoperative bleeding volume in the observation group was less than that in the control group,and the time for surgery and vaginal bleeding were shorter those that in the control group.The surgical clearance rate was higher than that in the control group,and the vaginal bleeding volume,uterine adhesion rate,and red blood cell aggregation rate were lower than those in the control group,with statistically significant difference(t=3.085,4.037,9.321;χ^(2)=4.427,6.793,4.387,7.256;P<0.05).Three months after surgery,the observation group had lower endometrial blood flow pulsatility index(PI),resistance index(RI),and menstrual bleeding chart(PBAC)scores,higher endometrial thickness during ovulation compared to the control group,and serum TGF levels-β1.The level of PAI-1 was lower than that of the control group,and the difference was statistically significant(t=2.934,2.860,3.947,2.753,5.311,4.254;P<0.05).Conclusion:Hysteroscopic cold knife resection has a positive significance in improving perioperative indicators and postoperative recovery of EP patients,and is beneficial for regulating endometrial blood flow and thickness,reducing menstrual flow,and improving TGF-β1 and PAI-1 level.