基于炎性因子、卵巢功能、安全性评价宫腔镜子宫内膜电切术治疗子宫异常出血的临床疗效

Clinical efficacy of hysteroscopic electrohysterectomy for abnormal uterine bleeding based on inflammatory factors,ovarian function and safety

目的:探究宫腔镜子宫内膜电切术(Hysteroscopic transcervical resection of endometrial,TCRE)治疗子宫异常出血(Abnormal uterine bleeding,AUB)的效果。方法:选取2020年1月至2023年4月本院收治的92例AUB患者作为研究对象。随机将患者分为对照组和观察组,每组各46例。对照组接受宫腔镜刮除术治疗;观察组接受TCRE治疗。对比两组的围术期指标,于术后3m对比两组手术效果、并发症,对比两组术前、术后1m、术后3 m卵巢功能[雌二醇(Estradiol,E2)、促黄体生成激素(Luteinizing hormone,LH)、促卵泡生成激素(Follicle stimulating hormone,FSH)],对比两组术前、术后1 d、术后3 d的炎性因子水平。结果:观察组的手术优良率高于对照组(P<0.05)。观察组的并发症发生率低于对照组(P<0.05)。观察组术中失血量显著低于对照组,住院用时、术后下床及排气时间均短于对照组(P<0.05)。观察组术后1 m、3 m血清LH、FSH水平均低于对照组,E2水平均高于对照组(P<0.05)。观察组术后1 d、3 d的血清炎性因子水平均低于对照组(P<0.05)。结论:TCRE治疗AUB患者,能减少并发症,提升手术效果,优化围术期指标,改善卵巢功能。

Objective:To investigate the efficacy of hysteroscopic transcervical resection of endometrium(TCRE)in treating abnormal uterine bleeding(AUB).Methods:92 patients with AUB admitted to our hospital from January 2020 to April 2023 were selected as the study objects.The patients were randomly divided into control group and observation group,with 46 cases in each group.The control group received hysteroscopic curettage,and observation group received TCRE treatment.The perioperative indicators of the two groups were compared,and the surgical effects and complications were compared between the two groups at 3 months after surgery.The ovarian functions[estradiol(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH)]were compared between the two groups before and after surgery for 1 month and 3 months,and the inflammatory factors were compared between the two groups before and after surgery for 1 day and 3 days.Results:The excellent or good rate of operation in observation group was higher than that in control group(P<0.05).The complication rate of the observation group was lower than that of the control group(P<0.05).The intraoperative blood loss in the observation group was lower than that in the control group,and the time spent in hospital,getting out of bed after operation and exhaust time were shorter than those in the control group(P<0.05).Serum LH and FSH levels in observation group were lower than those in control group 1 month and 3 months after operation,and E2 levels were higher than those in control group(P<0.05).Serum levels of inflammatory factors in the observation group were lower than those in the control group one day and three days after surgery(P<0.05).Conclusion:TCRE can reduce complications,improve operative results,optimize perioperative indexes,and improve ovarian function in AUB patients.