LiNA OperaScope^(TM) for microwave endometrial ablation for endometrial polyps with heavy menstrual bleeding: A case report

BACKGROUND The procedure for microwave endometrial ablation(MEA)follows established MEA practice guidelines but requires hysteroscopic observation of the uterine lumen before and after MEA.When a luminal uterine lesion is recognized,its removal requires preoperative dilation of the cervix because the outer diameter of a conventional rigid hysteroscope is 8.7 mm.Recently,a fully disposable rigid hysteroscope(LiNA OperaScope^(TM))with a narrow diameter(4.4 mm)and forceps capable of extracting endometrial lesions has become available.CASE SUMMARY Here,we report a case of heavy menstrual bleeding(HMB)complicated by endometrial polyps where MEA was performed after removing endometrial polyps using the LiNA OperaScope^(TM) device.A 48-year-old woman with three prior pregnancies and three deliveries was referred to our hospital for further examination and treatment after being diagnosed with HMB 2 years earlier.The patient underwent MEA following endometrial polypectomy using LiNA OperaScope^(TM).After MEA,endometrial cauterization was again examined using the LiNA OperaScope^(TM),and the procedure was completed.No preoperative cervical dilation was performed.The patient’s clinical course was favorable,and she was discharged 3 h after surgery.One month after surgery,menstruation resumed,and both HMB and dysmenorrhea improved markedly from 10 preoperatively to 1 postoperatively,as assessed subjectively using the visual analog scale.The patient’s postoperative course was uneventful with no complic-ations.CONCLUSION LiNA OperaScope^(TM) can be a minimally invasive treatment for MEA of HMB with uterine lumen lesions.

Multicentric Study on Endometrial Polyps and Endometriosis: Are They True or False Friends?

Many authors have reported an epidemiologic relationship between endometrial polyps and endometriosis. The joining link could be an unopposed and unbalanced estrogenic milieu. The prevalence of both, endometrial polyps and endometriosis, is quite high among general population. The presence of endometrial polyps and endometriosis could affect infertile women. We performed a retrospective multicentric study, based on data collected from three Hospitals (S. Antonio Abate, Trapani, Civico-Ascoli, Palermo, and Cannizzaro, Catania). We analyzed 285 women undergoing diagnostic/office hysteroscopy. Clinical history demographic and hysteroscopic data were collected in the same sheet, containing within informed consent. On the base of our results no relationship exists between endometrial polyps and endometriosis nor cervical polyps. It’s the first time that none correlation is proved for the coexistence of endometrial polyps and endometriosis. Further research is needed.

Vascular markers CD31,CD34,actin,VEGFB,and VEGFR2,are prognostic markers for malignant development in benign endometrial polyps

Intention of the study: The prevalence of endometrial polyps has been demonstrated in between 10% and 35% of all women, but knowledge regarding malignant potential within polyps is limited. Even though premalignant and malignant changes have been reported in up to 24% of all cases, no objective tissue markers have ever been developed for routine diagnostics to select high risk cases. As vascular changes and activation of endometrial angiogenesis has been demonstrated in former studies, our main objective was to evaluate different members of the angiogenic pathway as potential risk factors for cancer development. Patients and methods: Formalin-fixed, paraffin-embedded tissue from 15 women with benign endometrial polyps, and 16 women diagnosed with endometrial cancer were included. Immunohistochemical investigation with antibodies against VEGF, VEGF-B, VEGFR2, VEGFR3, CD31, CD34, actin, and factorVIII was performed, followed by evaluation of staining intensity of microvessels, evaluation of H-score in glands (cell membrane, cytoplasm) and stroma, and measurement of micro vessel density. Results: Expression of CD31 in microvessels was significantly stronger in cancers compared to endometrial polyps (P = 0.006 for arterioles, P = 0.038, for venyles, and P = 0.002 for capillaries, respectively), whereas, a reverse change was shown for CD34. Expression of actin in capillary walls was also significantly increased in cancers compared to polyps (P = 0.002). No significant difference was found for staining intensity in microvessels (arterioles, venyles or capillaries) in endometrial benign polyps compared with endometrial cancers for VEGF, VEGFB, VEGFR2, VEGFR3, or Factor VIII. Also no difference in H-score values between benign polyps and endometrial cancers could be detected in glandular epithelium, in epithelial cell membrane or in stroma for VEGFR3, CD31 or Factor VIII. Conclusions: The present study strongly indicates that activation of angiogenesis differs in benign endometrial polyps and endometrial cancers. Thus, immunohistochemical expression of specific angiogenic markers may be of great importance as prognostic factors in the routine diagnostics of this lesion. The ratio between stromal expression of CD34 and actin might be of particular interest to select polyps with increased malignant potential.

Endometrial Polyps:Which Patients Should Be Selected for Hysteroscopic Surgery?--A Study Using Data from the Swedish National Quality Registry of Gynecological Surgery

Objective: To illuminate the findings after hysteroscopic surgery of endometrial polyps. Method: Data were extracted from The Swedish National Quality Registry of Gynecological Surgery. Endometrial polyps were identified in 1934 cases in a total of 4512 hysteroscopic operations. Data on all hysteroscopic procedures registered as surgery of endometrial polyps between 1997 and January 2013 were analyzed with logistic regression analysis and effect size was calculated. Main outcome measure was malignancy in endometrial polyps. Results: The most frequently reported symptoms of endometrial polyps were: postmenopausal bleeding, metrorrhagia, pain, and infertility. Among the registered biopsies, there were: 30 malignancies (1.8%), and 41 dysplasias (2.5%). The remaining polyps were benign. Only 1/30 cancer patients were <52 years old (p < 0.001). Among those women with dysplasia, 12/41 (29%) were p = 0.07). All cancer patients at age ≥52 had postmenopausal bleeding. The <52-year-old cancer patient had treatment-resistant bleeding. Increasing weight was a risk factor associated with tissue alterations in endometrial polyps (p = 0.014), controlling for age as a confounding factor. Conclusion: Hysteroscopic surgery should be recommended for women with postmenopausal bleeding and presence of endometrial polyps according to the findings of this study. The results further indicate a low risk of malignancy in premenopausal women <52 years with endometrial polyps. In those cases, it seems to be safe to refrain from surgery.

Application of Whole-Process Management in Day Surgery for Endometrial Polyp

Objective:To explore the effect of whole-process management model in nursing management of endometrial polyp day surgery.Methods:266 patients that underwent endometrial polyp day surgery from January to December 2022 were selected for this study,and they were separated into an observation group(131 patients)and a control group(135 patients);the clinical data of the two groups were compared.Results:After intervention,the scores of Hamilton Anxiety Scale(HAM-A)of the patients in the observation group were lower than those in the control group(P<0.05).The rate of postoperative complications in the observation group was lower than that in the control group(P<0.05),and the satisfaction degree of the patients in the observation group was higher than that in the control group(P<0.05).Conclusion:The application of the whole-course management model in endometrial polyp day surgery can alleviate patients’anxiety,ensure the quality and safety of day surgery nursing,and improve patients’satisfaction.

Effects of Huayu Xiaozheng Therapy on Recurrence of Multiple Endometrial Polyps After Electrotomy

Objective:To investigate the preventive effect of Huayu Xiaozheng therapy method of traditional Chinese medicine on the recurrence of multiple endometrial polyps after hysteroscopic electro resection.Methods:A total of 120 patients with blood stasis diagnosed with multiple endometrial polyps after hysteroscopic electroresection were divided into Traditional Chinese medicine group(38 people),Manyuele group(27 people),contraceptive pill group(34 people)and control group(21 people),and the endometrial thickness,polyp recurrence cases and TCM syndrome points were observed in 4 groups after treatment in 3 months,6 months and 12 months..Results:The endometrial thickness was statistically significant(P<0.05)before and after treatment in the Chinese medicine group,the Manyuele group and the contraceptive group,and the endometrial thickness was statistically significant(P<0.05)in the 1 year after treatment,and the endometrial thickness of the Chinese medicine group was compared with the contraceptive group and the Manyuele group in the 1 year after treatment,and the difference was not statistically significant.The differences in TCM symptoms in the Chinese medicine treatment group were statistically significant compared with those in the contraceptive group and the Manyuele group(P<0.05).The recurrence rate of polyps in the 1 year after treatment was statistically significant compared with the control group(P<0.05),and the difference between the three groups was not statistically significant(P>0.05).Conclusion:The traditional Chinese medicine stasis elimination method has a preventive effect on the recurrence of endometrial polyps,and its preventive effect is no different from that of Western medicine,and can significantly improve clinical symptoms.

前列腺素受体EP_2在子宫内膜癌中的表达

目的 研究前列腺素 (PGE2 )受体EP2 在子宫内膜癌中的表达 ,探讨EP2 在子宫内膜癌中的表达变化与雌激素受体依赖的关系 ,以及在子宫内膜癌的发生、发展过程是否存在非雌激素受体的作用。方法5 0例子宫内膜癌组织 (Ⅰ期 2 9例、Ⅱ期 7例、Ⅲ期 1 2例、Ⅳ期 2例 ,G1级 2 6例、G2级 1 5例、G3级 9例 ) ,正常子宫内膜 1 0例 ,术前未经放化疗及激素等内分泌治疗。应用逆转录 -聚合酶链反应 (RT -PCR)技术 ,半定量研究各组中EP2 的mRNA表达。结果 子宫内膜癌G1组、G2组、G3组均高于正常组 ,差异有统计学意义 (P<0 0 5 ) ,而且随细胞分化越差 ,EP2 受体表达水平呈上升趋势 ,差异有统计学意义 (P <0 0 0 1 ) ;子宫内膜癌Ⅰ期组、Ⅱ～Ⅳ期组均高于正常组 ,差异有显著统计学意义 (P =0 0 0 1 ) ,并随分期变化 ,分期越晚 ,表达值升高 ,期别之间相比差异无统计学意义 (P =0 1 7) ;在子宫内膜癌中 ,雌激素受体表达阴性组比阳性组的EP2表达水平显著升高 ,差异有统计学意义 (P <0 0 0 1 ) ;而孕激素受体表达阴性组与阳性组的EP2 表达相比较差异无统计学意义 (P >0 0 5 ) ;绝经前 (2 0例 )与绝经后 (30例 )患者的子宫内膜癌中EP2 的表达分别为 0 90 5±0 2 5 1和 0 94 1± 0 336 ,二者差异无统计学意义 (P

生化汤在子宫内膜息肉术后的应用效果

目的研究生化汤加减应用于子宫内膜息肉(EP)术后对患者子宫内膜厚度、月经周期等的影响。方法选择2020年3月—2022年3月在南昌市洪都中医院进行宫腔镜下电切手术治疗的EP患者70例,采取随机数字表法分为对照组及观察组,各35例。对照组术后予西药去氧孕烯炔雌醇片、醋酸环丙孕酮片等,观察组在此基础上予生化汤加减,对比两组治疗前后的月经周期、子宫内膜厚度及中医证候积分(经漏、经血色暗、小腹疼痛)。结果治疗后,两组月经周期均短于治疗前、子宫内膜厚度均小于治疗前,且观察组月经周期短于对照组、子宫内膜厚度小于对照组(P<0.05)。治疗后,两组经漏、经血色暗等中医证候积分均低于治疗前,且观察组各项中医证候积分均低于对照组(P<0.05)。结论EP患者术后应用生化汤加减,可促进其相关症状的转归、月经周期的复常,并抑制子宫内膜增生。

Impact of gonadotropin-releasing hormone agonist and hormone replacement therapy on pregnancy outcomes in single euploid frozen-thawed embryo transfer for patients with endometrial polyps

Objective:Although consensus on the optimal endometrial preparation protocol for frozen-thawed embryo transfer(FET)is lacking,this is particularly true for patients with infertility and a history of endometrial polyps(EPs).In this study,we aimed to investigate whether a gonadotropin-releasing hormone agonist combined with hormone replacement therapy(GnRHa-HRT)could improve pregnancy outcomes in single euploid FET for patients with a history of EPs.Methods:In this retrospective cohort study,395 women who underwent their first single euploid FET cycle were divided into groups according to endometrial preparation protocols as follows:natural cycle(NC)(n=220),hormone replacement therapy(HRT)(n=122),and GnRHa-HRT groups(n=53).Subsequently,the FET cycles in the three groups were subdivided according to maternal age.All patients underwent hysteroscopic polypectomy before FET,and their EPs were confirmed by pathology.Results:No statistically significant differences were observed in live birth rates among the three groups(58.64%vs.58.20%vs.56.60%,P=0.964).Furthermore,the rates of miscarriage,ectopic pregnancy,premature live birth,and pregnancy complications were comparable among the three groups(P>0.05).After adjusting for potential confounding factors,no significant differences in pregnancy outcomes were reported between the groups(adjusted odds ratios[OR]and 95%credible intervals[CI]for live birth rate,HRTvs.NC:1.119,0.660–1.896,P=0.677;GnRHa-HRTvs.NC:1.165,0.610–2.226,P=0.643).Additionally,the pregnancy outcomes of the FET cycle were not influenced by the endometrial preparation protocols in the subgroups when stratified by maternal age(P>0.05).Conclusion:GnRHa-HRT did not improve the pregnancy outcomes of the single euploid FET in patients with a history of EPs.

雌、孕激素受体及表皮生长因子受体在EP中的表达和宫腔镜对EP的诊治价值

目的： 探讨雌激素受体（ER）、孕激素受体（PR）、表皮生长因子受体（EGFR）在子宫内膜息肉（EP）中的表达及宫腔镜对EP的诊断和治疗价值.方法： 360例EP患者中56例行经宫颈EP电切术（TCRP）,对30例EP患者息肉组织、息肉旁内膜组织和10例正常子宫内膜中EGFR、ER、PR的表达进行检测,并对各组织间质、腺体中EGFR、ER、PR的表达进行比较. 结果：56例行TCRP的EP患者中,2例病理诊断为高分化子宫内膜腺癌,行全子宫切除术,随访6个月～1年,患者预后良好.宫腔镜手术后3个月随访,除4例患者宫腔底部有轻度粘连外,余患者宫腔形态正常,症状明显改善.（3）子宫息肉组织间质和腺体中ER、PR、EGFR的表达均明显高于息肉旁组织及正常内膜的表达（P〈0.05）;息肉旁内膜组织腺体和间质中ER、PR及间质中EGFR的表达与正常子宫内膜组织差异无统计学意义（P〉0.05）;息肉旁内膜组织腺体EGFR的表达明显高于正常内膜的表达（P〈0.05）;息肉组织腺体ER的表达明显高于间质的表达（P〈0.05）,息肉组织腺体EGFR的表达明显高于间质的表达（P〈0.01）.结论：（1）EP的临床特征以不规则阴道出血为主,绝经期则以绝经后出血为主;（2）EP的发生与EGFR、ER、PR协同作用有关;（3）绝经后妇女体内仍有雌激素持续作用;（4）宫腔镜是EP诊断和治疗的首选方法,切除息肉同时息肉旁内膜也应酌情切除.

单发和多发EP患者息肉组织中ER、VEGF和TGF-β1表达的差异及预后分析

目的探讨多发子宫内膜息肉(EP)和单发EP患者息肉组织中雌激素受体(ER)、血管内皮生长因子(VEGF)和转化生长因子β1(TGF-β1)的表达水平,并分析其与预后的关系。方法选取行宫腔镜手术治疗的育龄期EP患者100例,其中多发EP(>5个)和单发EP各50例,以因输卵管因素行宫腔镜检查的患者35例作为正常内膜组,采用免疫组化法和逆转录聚合酶链反应(RT-PCR)检测ER、VEGF和TGF-β1在正常子宫内膜组织和单发EP、多发EP组织中的表达量。采用Kaplan-Meier曲线分析EP患者的复发率。采用Cox回归分析评估EP的复发风险。结果多发EP组和单发EP组息肉组织中ER、VEGF和TGF-β1mRNA及蛋白的相对表达量均高于正常内膜组的子宫内膜组织(P<0.05),且多发EP组均高于单发EP组(P<0.05)。多发EP组复发率(42.0%)明显高于单发EP组(12.0%)(P=0.001)。Cox回归分析结果显示,合并子宫内膜异位症[风险比率(HR)=2.718,95%可信区间(CI)1.179~6.262]和EP多发(HR=4.134,95%CI1.663~10.273)是EP复发的独立危险因素,VEGF(HR=1.073,95%CI1.014~1.136)和TGF-β1(HR=1.056,95%CI1.005~1.109)高表达是多发EP患者复发的独立危险因素。结论多发EP患者息肉组织中ER、VEGF和TGF-β1高表达与术后高复发率密切相关。

TCRP联合曼月乐治疗EP的临床效果

目的分析宫腔镜子宫内膜息肉电切术联合曼月乐治疗子宫内膜息肉(EP)的临床效果。方法选取2011年11月至2013年11月在陕西中医药大学第二附属医院妇科治疗的68例EP患者,采用宫腔镜子宫内膜息肉电切术(TCRP)一次性去除EP,术后按患者的意愿分组,对照组:35例,单纯行TCRP术,术后无任何其它治疗;观察组:33例,行TCRP治疗后宫内放置曼月乐(LNG-IUS)。观察两组术前及术后第1、6、12个月子宫内膜厚度,并随访术后24个月的复发情况。结果术前及术后1个月两组子宫内膜厚度比较均无统计学意义(均P>0.05);随着治疗时间的延长,子宫内膜逐渐变薄,术后6、12个月时观察组子宫内膜厚度较对照组同期明显变薄(t值分别为2.445、2.732,均P<0.05);术后24个月观察组有2例复发,占6.06%,对照组8例复发,占22.86%,两组比较差异有统计学意义(χ2=7.236,P<0.05)。结论宫腔镜子宫内膜息肉电切术后联合曼月乐可抑制子宫内膜增生,并明显降低EP的复发率,值得在临床推广应用。

The Intrauterine Bigatti Shaver for Endometrial Lesions: Our Experience and Modifications

Background: Removal of endometrial polyps and submucosal fibroids by blind avulsion or excision with resectoscope is associated with risks such as fluid imbalance and uterine perforation. This review describes our centre’s experience with the intrauterine Bigatti shaver (IBS), a new method for resecting these lesions. Methods: All procedures performed between August 2015 and June 2016 were included. Patient demographics and operation details (set-up time, resection time, operative findings and complications) were collected at time of surgery using a standardised form. Results: 21 cases were performed between August 2015 and June 2016 by two senior gynaecologists. The majority (18, 86%) were performed for polyps associated with menstrual abnormalities or subfertility. Mean operating time was 9.6 minutes (range 3 - 25), median fluid input 1450 mls (range 700 - 3000) and median fluid deficit 100 mls (range 50 - 300). There were no cases of infection, perforation or fluid overload. The IBS blade was bent after resection of an anterior wall polyp in an anteverted uterus. A 3 mm grade 1 submucosal fibroid could not be resected as it was too hard in consistency. Conclusions: The constant clear visualisation provided by the continuous flow of fluid enabled fast and complete resection of sizeable polyps with minimal fluid deficit. No serious complications occurred despite this being the initial series performed by both surgeons. Bending of the blade may be avoided by rotating the camera such that the operating channel is situated just next to the lesion. A drainage sock was fashioned out of ribbon gauze and attached to the end of the suction tubing for collection of small polyp fragments. The IBS is a valuable addition to current methods for resection of endometrial polyps. Further study is required to determine its utility for submucosal fibroids, particularly those with a hard consistency.

Endometrial Scratch-Suction and Implantation Failure

Objective: The aim of this trial was to determine whether endometrial scratch-suction caused by insertion tube of (IUCD) with suction improved the probability of pregnancy in the subsequent IVF cycle in patients who had previous failed IVF outcome by removing small polyps and any hazardous materials. Design: Observational prospective cohort experimental study. Setting: Zagazig University Hospital, Obstetrics and Gynecology department. From period between September 2011 till September 2012. Population: 30 patients with previous failed IVF despite transfer of goodquality embryos were allocated to endometrial scratch-suction in the same the cycle of embryo transfer. Methods: From day 5 to day 7 of same ICSI cycle, the patients in study underwent endometrial scratch-suction technique. After preparation of insertion tube of (IUCD) and infant feeding tube 8 F, moving the insertion tube of IUCD from below upwards with scratching anterior uterine wall, then posterior, then left lateral uterine wall, then right lateral uterine wall, then fundus, all these steps are associated with suction by attaching proximal end of infant feeding tube 8 F to suction apparatus. Main Outcome Measures: Implantation and clinical pregnancy rates. Results: The implantation occurred in 24/30 (80%). The clinical pregnancy occurred in 20/30 patients (66.66%). 12/30 patients (40%) during scratch-suction technique had small fleshy masses obstructing suction tube which were small endometrial polyps. Conclusions: Endometrial scratch-suction improves clinical pregnancy and implantation rates in the same IVF-ET cycle in patients with previous unsuccessful IVF cycles.

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。

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。

经阴道二维超声对子宫内膜息肉及子宫内膜息肉病变诊断的应用价值

目的探讨经阴道二维超声对子宫内膜息肉及子宫内膜息肉病变诊断的应用价值。方法选取2019年1月至2022年1月在本院就诊的患者46例,据病理检查结果将其分为息肉组和病变组。记录两组患者临床资料、BMI、超声指标(子宫内膜厚度、病灶最大直径、病灶回声不均匀、血流丰富),并以病理检查为金标准,分析经阴道二维超声诊断价值。结果依据病理检查检查显示,息肉组30例,病变组16例。两组患者年龄、产次0次占比比较差异无统计学意义(P>0.05),两组患者BMI≥24kg/m^(2)、绝经后出血比较差异具有统计学意义(P<0.05);病变组子宫内膜厚度、病灶最大直径、病灶回声不均匀占比、血流丰富占比均显著高于息肉组,差异均具有统计学意义(P<0.05);以病理结果作为金标准,灵敏度为67.50%(27/40),特异度为16.67%(1/6),阳性预测值为84.38%(27/32),阴性预测值为7.14%(1/14),符合率为60.87%(28/46)。结论经阴道二维超声可作为辅助手段用于子宫内膜息肉及其病变的早期诊断和鉴别诊断。

体重指数、腰臀比及胰岛素抵抗与绝经后子宫内膜息肉发病的相关性分析

目的探究体重指数(BMI)、腰臀比(WHR)及胰岛素抵抗(IR)与绝经后子宫内膜息肉(EP)发病的相关性。方法选取2021年10月至2023年1月资阳市人民医院收治的180例怀疑为绝经后EP患者作为研究对象。根据病理检查结果将其分为EP组(n=90)和非EP组(n=90)。比较两组的BMI、WHR、IR发生情况、性激素水平,分析BMI、WHR及IR与绝经后EP发病的关系。结果EP组的BMI、腰围、臀围、WHR均高于对照组(P<0.05);EP组空腹血糖(FBG)、空腹胰岛素(FIN)、稳态模型胰岛素抵抗指数(HOMA-IR)水平及IR发生率均高于非EP组(P<0.05);两组黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E_(2))、孕酮(P)水平比较,差异无统计学意义(P>0.05);EP患者BMI、WHR与HOMA-IR均呈正相关(P<0.05);BMI、WHR、HOMA-IR是EP发生的独立危险因素。结论BMI、WHR、HOMA-IR与绝经后EP发生均具有相关性,临床需重视肥胖、胰岛素水平过高患者,定期进行妇科检查。

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。

温阳化浊方对不孕症合并子宫内膜息肉患者TCRP术后妊娠结局的影响

[目的]回顾性分析温阳化浊方对不孕症合并子宫内膜息肉患者行宫腔镜子宫内膜息肉电切除术(TCRP)后妊娠结局的影响。[方法]筛选不孕症合并子宫内膜息肉患者109例作为研究对象,按照患者术后是否服用温阳化浊方进行分组,试验组71例,对照组38例。分析两组患者TCRP术后1年内的妊娠结局、子宫内膜息肉是否复发以及月经改善情况。[结果]试验组活产率、持续妊娠率、子宫内膜息肉复发率及月经改善情况优于对照组(P<0.05)。[结论]温阳化浊方可显著改善不孕症合并子宫内膜息肉患者TCRP术后的妊娠成功率,降低不孕症患者的子宫内膜息肉复发率,改善不孕症患者的月经状况。