Uterine artery pseudoaneurysm caused by hysteroscopic surgery: A case report

BACKGROUND We report a case of uterine artery pseudoaneurysm(UAP)occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization(UAE).CASE SUMMARY A 48-year-old primigravid,primiparous patient was incidentally found to have an endometrial polyp during a health checkup,and underwent a hysteroscopic polypectomy at another hospital.Her cervix was dilated with a Laminken-R®device.After the Laminken-R®was withdrawn,a large amount of genital bleeding was observed.This bleeding persisted after the hysteroscopic polypectomy,and,as hemostasis became impossible,the patient was transferred to our hospital by ambulance.On arrival,transvaginal ultrasonography revealed a 3-cm hypoechoic mass with a swirling internal pulse on the right side of the uterus,and color Doppler ultrasonography showed feeder vessels penetrating the mass.Pelvic contrast-enhanced computed tomography(CT)confirmed the presence of a mass at this site,and vascular proliferation was observed within the uterine cavity.Consequently,UAP was diagnosed,and UAE was performed.The patient’s postoperative course was uneventful,and 6 mo post-UAE,no recurrence of blood flow to the UAP was observed.CONCLUSION When abnormal genital bleeding occurs during hysteroscopic surgery,ultrasonography and contrast-enhanced CT can assist in the detection of early UAPs.

Managing uterine artery pseudoaneurysm post-hysteroscopic surgery:Clinical insights and future directions

This editorial discusses the case report by Kakinuma et al,which details a rare occurrence of uterine artery pseudoaneurysm following hysteroscopic surgery.The case highlights diagnostic challenges and management strategies for this uncommon complication.The editorial explores the implications for clinical practice,emphasizing the importance of early recognition and appropriate intervention to prevent potential severe outcomes.Future research directions to increase the understanding and management of uterine artery pseudoaneurysm in similar clinical settings.

Timely identification and treatment of uterine artery pseudoaneurysm after hysteroscopic procedures

Uterine artery pseudoaneurysm(UAP)is a rare but potentially life-threatening complication that can occur following hysteroscopic surgery for endometrial polyp resection.This article discusses the case study by Kakinuma et al,which highlights the successful diagnosis and treatment of UAP in a 48-year-old primiparous woman.Utilizing advanced imaging techniques such as ultrasound and computed tomography(CT),the medical team was able to promptly identify the UAP and subsequently perform a uterine artery embolization to treat the condition.The study underscores the critical need for rapid diagnosis and intervention to prevent severe outcomes and provides practical clinical recommendations for managing similar cases.This article aims to expand on the study’s findings,discuss the clinical implications,and suggest future research directions to optimize the management of UAP post-hysteroscopic surgery.

Evaluation of the Efficacy and Effectiveness of Hysteroscopic Electroresection in the Treatment of Submucosal Uterine Fibroids

Objective:To evaluate the effect of hysteroscopic electroresection in treating submucosal uterine fibroids.Methods:Using the random number table method,70 patients with submucosal uterine fibroids were divided into two groups,35 cases/group.The control group underwent laparoscopic myomectomy,and the observation group underwent hysteroscopic electroresection.Surgical indicators,sex hormone indicators,inflammation indicators,and treatment effects were compared between the two groups.Results:The surgical indicators,sex hormone indicators,and inflammatory indicators three months after operation in the observation group were all more ideal than those of the control group.The total effective rate of the observation group(97.14%)was higher than that of the control group(P<0.05).Conclusion:Hysteroscopic electroresection for the treatment of submucosal uterine fibroids was less invasive,accelerates recovery,and is more effective.

Successful live birth following hysteroscopic adhesiolysis under laparoscopic observation for Asherman’s syndrome: A case report

BACKGROUND Asherman’s syndrome is characterized by reduced menstrual volume and adhesions within the uterine cavity and cervix,resulting in inability to carry a pregnancy to term,placental malformation,or infertility.We present the case of a 40-year-old woman diagnosed with Asherman’s syndrome who successfully gave birth to a live full-term neonate after hysteroscopic adhesiolysis under laparoscopic observation,intrauterine device insertion,and Kaufmann therapy.CASE SUMMARY A 40-year-old woman(Gravida 3,Para 0)arrived at our hospital for specialist care to carry her pregnancy to term.She had previously undergone six sessions of dilation and curettage owing to a hydatidiform mole and persistent trophoblastic disease,followed by chemotherapy.She subsequently became pregnant twice,but both pregnancies resulted in spontaneous miscarriages during the first trimester.Her menstrual periods were very light and of short duration.Hysteroscopic adhesiolysis with concurrent laparoscopy was performed,and Asherman’s syndrome was diagnosed.The uterine adhesions covered the area from the internal cervical os to the uterine fundus.Postoperative Kaufmann therapy was administered,and endometrial regeneration was confirmed using hysteroscopy.She became pregnant 9 mo postoperatively and delivered through elective cesarean section at 37 wk of gestation.The postpartum course was uneventful,and she was discharged on postoperative day 7.CONCLUSION Hysteroscopic adhesiolysis with concurrent laparoscopy enables identification and resection of the affected area and safe and accurate surgery,without complications.

Clinical observation of hysteroscopic surgery combined with ectopic pregnancy ⅱ decoction and methotrexate in the treatment of cesarean scar pregnancy

Objective:To explore the effectiveness and safety about the treatment of Caesarean Scar Pregnancy combined hysteroscopic surgery with extopic pregnancy Ⅱ decoction and methotrexate(MTX).Methods: A total of 80 cases of CSP patients admitted by our hospital from January 2014 to March 2017 were selected as the subjects. According to the treatment way, the patients were divided into experimental group (n=40) and control group (n=40). The control group was given MTX 50 mg/m2, IM once;and the experimental group was given extopic pregnancy Ⅱ decoction on the basis of the treatment given to the control group;the 8th day hysteroscopic surgery. Routine treatment was given after surgery. Experimental group continued to take extopic pregnancy Ⅱ decoction until monitoring the serum beta-hcg level drops below normal. The general information and curative effect, HCG levels before and after 4, 7 and 11d of treatment;mass diameter before and after 11 d of treatment, menstruation recovery time and the incidence of adverse reactions in 2 groups were observed.Results:After hysteroscopic surgery pretreatment with extopic pregnancy Ⅱ decoction and MTX, HCG levels after 4, 7 and 11d were significantly lower than before, it gradually reduced by time prolonged, and research group was lower than control group, the differences were statistically significant. After treatment with different drugs, the size of pregnancy package in the observation group was significantly smaller than that in the control group. Compared with the control group, the he package block size, beta HCG time and vaginal bleeding time were significantly reduced.Conclusion: It has significant clinical effect of hysteroscopic surgery combined with ectopic pregnancy Ⅱ and MTX in the treatment of CSP. It has worthy of clinical promotion to control the amount of blood, avoid intrauterine adhesion caused by uterine artery embolization and infection et al and reduce burden of the physical and economic of patients.

The cervical function and pregnancy outcomes after hysteroscopic resection of the complete uterine septum,duplicate cervix and vaginal septum

Objective:To evaluate cervical function and pregnancy outcomes after hysteroscopic resection of the complete uterine septum,duplicate cervix and vaginal septum with Metzenbaum scissors.Methods:Between January 2010 and December 2016,13 patients admitted to the Department of Obstetrics and Gynecology of Sir Run Run Shaw Hospital with complete uterine septum,duplicate cervix and vaginal septum,were enrolled into this study.The cervical and corporal septum was cut by Metzenbaum scissors,and residual septum was cut by micro scissors under hysteroscopy.The vaginal septum was cut with the unipolar electric knife.Results:The operation time was about 10±1.31 min.All the 13 patients present normal uterine cavities without scar formation under hysteroscopy at 3 months after operation,there was mild adhesions between anterior and posterior intrauterine wall on 2 cases.After operation,there were 13 pregnancies naturally conceived in 11 patients,10 deliveries.The live birth rate was 76.92%,the early miscarriage rate was 23.08%.The cesarean section ratewas 30%,the vaginal delivery ratewas 70%,and all were term births.Conclusion:The operation was simple,convenient,and fast,without any complications and cervical insufficiency.It was easy to have vaginal deliveries.

Experience in Surgical Coordination of Type III Cesarean Scar Pregnancy Removal with Combined Assistance of Hysteroscopy and Laparoscopy

Objective:This paper aims to summarize the operative nursing coordination essentials of type III cesareans car pregnancy removal.Methods:Six patients were recruited for this study,and the patient’s condition was fully evaluated before the operation.In addition,the personnel,environment,and materials were well prepared before the operation,and the preparation of special intraoperative instruments and equipment was perfected.Results:The operation is successfully performed in all six patients.Each surgery lasted 70 to 120 minutes with an average duration of 90 minutes.Postoperative blood loss was about 100-500 ml.Postoperative recovery was good without complications in all the patients.Conclusion:In summary,laparoscopic removal of gestational tissue from type III cesareans car pregnancy in conjunction with hysteroscopy ensures compete removal of gestational tissue,while avoiding damaging the surrounding organs and tissues,thus greatly avoiding common complications which usually occur during the surgery.Effective surgical coordination is helpful to further improve the success rate of the operation.

地屈孕酮辅助宫腔镜下子宫内膜息肉切除术治疗子宫内膜息肉的效果

目的观察地屈孕酮辅助宫腔镜下子宫内膜息肉切除术(TCRP)治疗子宫内膜息肉(EP)的效果。方法回顾性选取福鼎市医院2019年1月—2021年6月收治的EP患者120例,根据治疗方式分为TCRP组(n=60)和联合治疗组(n=60)。TCRP组患者接受宫腔镜下TCRP治疗,联合治疗组患者在TCRP组基础上加用地屈孕酮片治疗,药物治疗6个月经周期。2组患者均随访12个月。比较2组临床疗效,治疗前、治疗6个月后、治疗后12个月血红蛋白(Hb)、血清雌二醇(E2)、子宫内膜厚度、异常子宫出血发生率,随访12个月疾病复发率及不良反应。结果联合治疗组总有效率高于TCRP组(95.00%vs.83.33%,χ^(2)=4.227,P=0.040)。治疗6个月后及治疗后12个月,2组Hb水平高于治疗前,血清E2水平低于治疗前,且联合治疗组升高/降低幅度大于TCRP组(P<0.05或P<0.01);2组子宫内膜厚度、异常子宫出血发生率低于治疗前,且联合治疗组低于TCRP组(P<0.05或P<0.01)。2组随访12个月疾病复发率、不良反应总发生率比较,差异无统计学意义(P>0.05)。结论地屈孕酮辅助TCRP治疗EP的疗效确切,可有效降低异常子宫出血发生率,改善患者贫血症状,还可有效调节雌激素水平,进而抑制子宫内膜增生,且安全性较高。

对比分析宫腔镜冷刀技术与宫腔镜电切术治疗宫腔妊娠物残留的疗效及对子宫内膜再生的影响

目的对比分析宫腔镜冷刀技术与宫腔镜电切术治疗宫腔妊娠物残留的疗效及对子宫内膜再生的影响。方法前瞻性选取宝鸡市中心医院自2021年1月至2022年12月收治的82例宫腔妊娠物残留患者作为研究对象,所有患者均接受宫腔镜手术治疗,依据随机数字表法将其分为对照组和观察组,每组各41例。对照组行宫腔镜电切术治疗,观察组行宫腔镜冷刀技术治疗。比较两组术中情况(手术时间、术中出血量、苏醒时间、经济费用),术后恢复情况[术后住院时间、术后阴道出血时间、术后月经复潮时间、术后人绒毛膜促性腺素(HCG)恢复正常时间],术前及术后3个月、术后6个月的子宫内膜厚度、子宫内膜血流参数[阻力指数(RI)、搏动指数(PI)],一次性治愈率、月经量减少率、术后并发症发生率。结果观察组手术时间为(17.52±5.32)h,短于对照组[(23.09±6.57)h],差异有统计学意义(P<0.05);两组术中出血量、苏醒时间、经济费用比较,差异均无统计学意义(P>0.05)。观察组的术后住院时间、术后阴道出血时间、术后月经复潮时间、术后HCG恢复正常时间分别为(1.09±0.24)、(6.01±1.98)、(29.56±4.87)、(7.68±1.83)d,均短于对照组[(1.21±0.18)、(8.25±2.70)、(33.15±6.82)、(10.01±2.37)d],差异均有统计学意义(P<0.05)。两组术前及术后6个月的子宫内膜厚度、RI、PI比较,差异均无统计学意义(P>0.05);术后3个月,观察组的子宫内膜厚度、RI、PI分别为(8.96±1.57)mm、0.54±0.09、0.80±0.16,均大于对照组[(7.05±1.36)mm、0.42±0.05、0.70±0.13],差异均有统计学意义(P<0.05)。两组一次性治愈率比较,差异无统计学意义(P>0.05);观察组月经量减少率为2.44%,低于对照组(14.63%),差异有统计学意义(P<0.05)。观察组术后并发症发生率为4.88%,低于对照组(24.39%),差异有统计学意义(P<0.05)。结论宫腔镜冷刀技术与宫腔镜电切术治疗宫腔妊娠物残留的疗效相当,前者在促进术后恢复、减少并发症发生和保护子宫内膜上具有显著优势,值得临床予以重视应用。

瑞马唑仑联合阿芬太尼与丙泊酚联合阿芬太尼全凭静脉麻醉在宫腔镜电切手术麻醉中的应用比较

目的:探究在进行宫腔镜电切手术时,麻醉方案采用瑞马唑仑联合阿芬太尼、丙泊酚联合阿芬太尼两种全凭静脉麻醉方案的应用效果。方法:研究时间为2023年1月至2023年6月,纳入研究对象为107例宫腔镜电切手术患者,根据随机数字表法分为对照组、观察组。对照组53例采用丙泊酚联合阿芬太尼全凭静脉麻醉,观察组54例采用瑞马唑仑联合阿芬太尼全凭静脉麻醉。比较两组患者的疼痛情况(使用VAS评分评估)、镇静情况(采用Ramsay镇静评分评估)、生命体征情况、改良警觉/镇静评分,记录不良反应情况。结果:与对照组相比,观察组在术后2h及术后12h的VAS评分降低(P<0.05),术后2h时的Ramsay镇静评分升高(P<0.05)。两组在手术前的HR、SBP、DBP、SPO_(2)差异无统计学意义(P>0.05),与对照组患者相比较,观察组患者手术开始后5min及术后2h的HR、SBP、DBP、SPO_(2)水平均升高(P<0.05)。两组的VAS评分、Ramsay镇静评分、生命体征指标均具有显著的组间效应、时间效应及交互效应(P<0.05)。观察组患者手术结束后1min、3min、5min时MOAA/S评分比对照组高(P<0.05)。组间不良反应发生率差异无统计学意义(P>0.05)。结论:瑞马唑仑联合阿芬太尼应用于宫腔镜电切手术麻醉在术后早期具有更好的疼痛控制和镇静效果,且患者恢复清醒状态更快,生命体征水平维持更稳定。

宫腔镜手术联合曼月乐环放置治疗子宫内膜息肉临床疗效

目的 探讨宫腔镜手术联合曼月乐环放置治疗子宫内膜息肉的临床疗效。方法 将180例子宫内膜息肉患者依据治疗方法分为对照组(90例,宫腔镜手术)、试验组(90例,宫腔镜手术+曼月乐环)。治疗后,对比分析两组患者病症改善情况、不良反应及临床疗效。结果 治疗前试验组患者黄体生成激素(LH)、促卵泡生成素(FSH)、雌二醇(E2)水平及子宫内膜厚度与对照组比较差异无统计学意义(P>0.05);治疗后试验组各项指标均优于对照组(P<0.05)。试验组不良反应发生率为5.55%,显著低于对照组的15.55%(P<0.05);试验组患者的临床治疗有效率为97.78%,明显高于对照组的88.89%(P<0.05)。结论 采用宫腔镜手术联合曼月乐环放置方案治疗子宫内膜息肉能够防范子宫内膜增生等不良反应发生,有效改善临床病症,利于患者预后,疗效确切。

艾司氯胺酮在宫腔镜手术麻醉中的应用效果

目的 观察宫腔镜手术麻醉中应用艾司氯胺酮的效果。方法 选择择期接受宫腔镜手术的患者120例,随机分为E组和S组,各60例,E组退出1例。静脉诱导时,E组注射艾司氯胺酮,S组注射舒芬太尼。记录两组给药前(T_0)、诱导后(T_(1))、插管时(T_(2))、插管后1 min(T_(3))、插管后5 min(T_(4))、手术结束时(T_(5))血流动力学变化,以及术中体动、追加药物次数、镇静苏醒时间、麻醉恢复时间,抑郁自评量表(SDS)评分,术后恶心呕吐、头晕、多语等不良反应例数。结果 E组收缩压(SBP)(T_(1~3)、T_(5)时刻)、舒张压(DBP)(T_(1~4)时刻),心率(HR)(T_(2~6)时刻)高于S组(P<0.05)。两组体动、追加次数、镇静苏醒时间、麻醉恢复时间、不良反应指标、SDS评分差异无统计学意义(P>0.05)。结论 艾司氯胺酮具有血流动力学稳定、不良反应少的优点,可安全用于宫腔镜手术患者的麻醉。

DRG支付方式对宫腔镜手术的效果评价研究

目的:评价DRG支付方式对宫腔镜手术住院费用及医疗服务质量的效果。方法:收集2021-2022年安徽省某三甲综合医院697例宫腔镜手术病人数据,按付费方式分为DRG组(n=385)和非DRG组(n=312)。采用描述性统计分析、倾向性评分法、秩和检验,平衡病例间混杂因素后,检验DRG组和非DRG组住院费用及医疗服务质量情况。结果:经倾向性匹配后,DRG组与非DRG组宫腔镜手术病人的年龄、婚姻、住院时间、住院次数、手术级别、切口等级、麻醉方式差异均无统计学意义(P>0.05)。2组病人日均费用、自费金额、一般医疗服务费和护理费差异均有统计学意义(P<0.01);而总费用、诊断费用、手术治疗费、西药费、其他费用)、术前住院时间和是否有出院31 d内再住院计划差异均无统计学意义(P>0.05)。结论:DRG对样本医院宫腔镜手术控费作用不明显,对医疗服务质量水平影响亦不显著,医疗机构在费用结构与服务质量方面仍存在优化管理空间,应结合自身运营特点,对相关指标进行实时、针对性的监测与考核,实现医院控费提质“双控制”。

宫颈息肉宫腔镜下切除术后复发的风险预测可视化模型建立及效能验证

目的:建立宫颈息肉宫腔镜下切除术后复发的风险预测可视化模型,并验证其效能。方法:回顾性收集2019年1月-2022年7月于本院行宫腔镜下切除术的420例患者的临床资料,经计算机产生随机数表以2∶1将其分为训练集(280例)、验证集(140例)。所有患者均接受随访,将复发患者纳入复发组,其余纳入无复发组。比较训练集复发组、无复发组一般资料;用logistic回归模型分析宫颈息肉宫腔镜下切除术后复发的影响因素,并建立回归方程;用受试者工作特征曲线(ROC)、Calibration曲线、决策曲线评价模型的预测效能、校准能力及临床净获益。结果:随访时间12~36个月,中位随访时间18个月。训练集患者宫颈息肉宫腔镜下切除术后复发率11.79%;logistic回归模型显示,年龄、月经不规则、人乳头瘤病毒(HPV)感染、产次、术后未治疗是宫颈息肉宫腔镜下切除术后复发的影响因素(P<0.05);建立logistic回归方程:Y=0.563 X_(1)+0.752 X_(2)+0.854 X_(3)+0.621 X_(4)+0.806 X_(5);基于训练集logistic回归分析结构建立宫颈息肉宫腔镜下切除术后复发的风险预测列线图模型,该模型预测训练集、验证集术后复发的灵敏度分别为97.14%、94.29%,特异度分别为91.74%、80.73%,曲线下面积(AUC)分别为0.956、0.911;训练集、验证集Calibration曲线经Hosmer-Lemeshow检验,差异无统计学意义(P>0.05);Bootstrap法内部验证结果显示,训练集、验证集的C-index指数分别为0.911(95%CI:0.832~0.990)、0.905(95%CI:0.841~0.969);训练集、验证集分别在风险阈值0~0.83、0~0.61范围内获取临床净收益。结论:年龄、月经不规则、HPV感染、产次、术后未治疗是宫颈息肉宫腔镜下切除术后复发的影响因素,据此建立的风险预测列线图模型效能良好。

宫腔镜手术联合炔诺酮片治疗子宫内膜息肉的临床疗效及对复发率的影响

目的探讨宫腔镜手术联合炔诺酮片治疗子宫内膜息肉的临床疗效及对复发率的影响。方法选取2020年1月至2021年12月肇庆市中心人民医院收治的144例子宫内膜息肉患者作为研究对象,采用随机数字表法分为研究组与对照组,每组72例。对照组给予宫腔镜手术治疗,研究组在对照组基础上联合炔诺酮片治疗。比较两组子宫内膜厚度、血红蛋白、月经情况(月经量、月经周期)、激素指标[促卵泡素(FSH)、促黄体生成素(LH)及雌二醇(E2)]、临床疗效及术后6、12个月复发率。结果术后6个月,研究组子宫内膜厚度薄于对照组,血红蛋白水平高于对照组,差异有统计学意义(P<0.05);术后6个月,研究组月经量少于对照组,月经周期短于对照组,差异有统计学意义(P<0.05);术后6个月,研究组FSH、LH及E2水平均低于对照组,差异有统计学意义(P<0.05);研究组治疗总有效率高于对照组(88.89%vs.63.89%),差异有统计学意义(P<0.05);研究组术后6、12个月复发率均低于对照组,差异有统计学意义(P<0.05)。结论宫腔镜手术联合炔诺酮片治疗子宫内膜息肉效果显著,能有效改善患者子宫内膜厚度、血红蛋白水平、月经情况及雌、孕激素动态平衡状态,降低复发率。

宫腔镜手术配合术后孕激素治疗子宫内膜息肉患者的效果及对月经状况和复发率的影响分析

目的分析对于用宫腔镜手术治疗的子宫内膜息肉患者,配合术后孕激素治疗的效果及对月经状况和复发率的影响。方法方便选择2022年1月—2023年1月兰州市妇幼保健院收治的96例子宫内膜息肉患者为研究对象,并按照治疗方法的不同分为两组,每组48例。两组均接受宫腔镜手术治疗,在此基础上,对照组采用醋酸甲羟孕酮分散片治疗,观察组采用地屈孕酮治疗。比较两组治疗前后的月经量、月经期、子宫内膜厚度及雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)表达评分,复发率、并发症发生率、临床疗效。结果治疗后3个月和6个月,观察组月经量比对照组少,且月经期比对照组短,差异有统计学意义(P均<0.05)。治疗后3个月和6个月,观察组子宫内膜厚度比对照组小,差异有统计学意义(P均<0.05)。治疗后,观察组ER表达评分低于对照组,PR表达评分高于对照组,差异有统计学意义(P均<0.05)。观察组复发率为0,低于对照组的10.00%(4/40),差异有统计学意义(χ^(2)=4.824,P<0.05)。两组的并发症发生率比较,差异无统计学意义(P>0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论对于子宫内膜息肉患者,在开展宫腔镜手术治疗的基础上采用孕激素类药物(地屈孕酮)加强治疗,能够调节ER、PR水平,改善月经状况和子宫内膜厚度,降低复发风险,且安全性较高,增强临床治疗效果。

甲羟孕酮联合宫腔镜电切术治疗子宫内膜息肉不孕症的临床效果

目的:探讨子宫内膜息肉(EP)不孕症患者采用甲羟孕酮联合宫腔镜电切术治疗的临床效果。方法:选取2021年7月—2023年7月滨州市中心医院收治的共计86例EP不孕症患者,以随机数字表法分成研究组(43例)与对照组(43例),对照组采取宫腔镜电切术治疗,研究组采取甲羟孕酮联合宫腔镜电切术治疗,比较两组症状体征评分、子宫内膜厚度、月经量、性激素水平、血管内皮生长因子(VEGF)水平、复发率、月经正常率、妊娠率。结果:两组术后3个月症状体征各项评分均较术前下降,研究组均较对照组低,差异均有统计学意义(P<0.05);两组术后3个月子宫内膜厚度、月经失血图(PBAC)评分均较术前下降,研究组子宫内膜厚度较对照组薄,PBAC评分较对照组低,差异均有统计学意义(P<0.05);两组术后3个月黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)水平均较术前下降,研究组上述各指标水平均较对照组低,差异均有统计学意义(P<0.05);两组术后3个月VEGF水平均较术前下降,研究组较对照组低,差异均有统计学意义(P<0.05);研究组复发率(2.33%)较对照组(18.60%)低,差异有统计学意义(P<0.05);研究组月经正常率(93.02%)较对照组(76.74%)高,差异有统计学意义(P<0.05);研究组妊娠率(53.49%)较对照组(23.26%)高,差异有统计学意义(P<0.05)。结论:甲羟孕酮联合宫腔镜电切术应用于EP不孕症患者治疗中,能够改善症状体征及子宫内膜厚度,减少月经量,降低性激素、血清VEGF水平及复发率,提高月经正常率及妊娠率。

宫腔镜下子宫内膜息肉电切术治疗子宫内膜息肉的临床效果分析

目的:分析宫腔镜下子宫内膜息肉电切术治疗子宫内膜息肉的临床效果。方法:选取2021年1月—2022年1月北京市第二医院妇科收治的子宫内膜息肉患者100例作为研究对象,随机分为对照组和观察组,各50例。对照组给予常规宫腔镜检查联合刮宫术治疗,观察组给予宫腔镜下子宫内膜息肉电切术治疗。比较两组治疗效果、月经量恢复情况、临床手术相关指标、手术并发症。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.007)。术前,两组月经量情况比较,差异无统计学意义(P>0.05);两组术后3个月、术后6个月月经量均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组手术出血量少于对照组,手术时间、住院时间短于对照组,差异有统计学意义(P<0.001)。两组手术并发症发生率比较,差异无统计学意义(P>0.05)。结论:宫腔镜下子宫内膜息肉电切术治疗子宫内膜息肉的临床效果较好,能够促进患者的月经恢复,减少手术出血量,缩短手术时间和住院时间,并且安全性较高。

宫腔镜手术联合中医补肾调冲汤治疗宫腔粘连后月经不调的效果

目的探讨宫腔镜手术联合中医补肾调冲汤治疗宫腔粘连后月经不调的效果。方法选取本院66例宫腔粘连后月经不调患者为研究对象,以电脑随机法分为两组,各33例。对照组采用宫腔镜手术治疗,研究组采用宫腔镜手术联合中医补肾调冲汤治疗,比较两组的治疗效果。结果治疗后,研究组子宫内膜厚度大于对照组,中医证候积分低于对照组(P<0.05);治疗后,研究组自觉状态、社会功能及情志功能评分高于对照组(P<0.05);研究组治疗总有效率高于对照组(P<0.05)。结论宫腔镜手术联合中医补肾调冲汤治疗宫腔粘连后月经不调,疗效显著,有利于增加子宫内膜厚度,提高中医证候积分,改善患者的生活质量,有推广价值。