宫腔镜下刨削系统和电切术治疗子宫内膜息肉患者效果及对术后并发症和复发的影响

Effect of hysteroscopic shaving system and electrotomy in treating patients with endometrial polyps and its influence on postoperative complications and recurrence

摘要

目的 观察宫腔镜下刨削系统和电切术治疗子宫内膜息肉患者效果及对术后并发症和复发的影响。方法 回顾性分析本院2020年6月至2022年7月收治的83例子宫内膜息肉患者临床资料.宫腔镜下刨削系统切除子宫内膜息肉的44例患者作为刨削系统组,选择同期进行宫腔镜电切术切除子宫内膜息肉的39例患者作为电切术组.比较两组患者治疗效果及术后并发症和复发情况差异。结果 两组性别、年龄、平均病程等一般资料比较,差异无统计学意义(P＞0.05).刨削系统组手术时间、术中出血量、住院时间及膨宫液用量均低于电切术组(t值分别为10.421、18.310、7.651和8.983,P＜0.001);术后并发症总发生率比较无明显差异(χ²＝2.789,P＞0.05);刨削系统组月经恢复时间、首次月经量、首次月经经期持续时间显著低于电切术组(t值分别为7.695、3.457和2.869,P＜0.001);术后24h,两组黄体生成素(LH)、卵泡刺激素(FSH)水平均升高,且刨削系统组显著高于电切术组(t值分别为10.609和2.986,P＜0.05);刨削系统组术后复发率显著低于电切术组(χ²＝4.419,P＜0.05)。结论 通过宫腔镜刨削系统治疗能有效改善患者治疗效果,对卵巢功能影响较小,可降低术后复发率.

Abstract

Objective To observe the effect of hysteroscopic shaving system and electrotomy in treating patients with endometrial polyps and its influence on postoperative complications and recurrence. Methods A retrospective analysis of clinical data of 83 patients with endometrial polyps admitted to our hospital from June 2020 to July 2022 was conducted. 44 cases with endometrial polyps excised by hysteroscopic shaving system were selected as shaving system group, and 39 cases with endometrial polyps excised by hysteroscopic electrotomy during the same period were selected as electrotomy group. The differences in effect, postoperative complications and recurrence were compared between both groups. Results There were no statistically significant differences in general data such as gender, age, and average duration of disease between the two groups (P＞0.05). The surgical time, intraoperative blood loss, length of hospitalisation and dilated fluid volume in shaving system group were all lower than those in electrotomy group (t=10.421, 18.310, 7.651, and 8.983, respectively, P＜0.001). There was no significant difference in the total incidence of postoperative complications (χ²=2.789, P＞0.05). The menstrual recovery time, first menstrual volume and first menstrual duration in shaving system group were significantly lower than those in electrotomy group (t=7.695, 3.457, and 2.869, respectively, P＜0.001). At 24 hours after surgery, the levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) in both groups increased, with shaving system group significantly higher than electrotomy group (t=10.609 and 2.986, respectively, P＜0.05). The postoperative recurrence rate in shaving system group was significantly lower than that in electrotomy group (χ²=4.419, P＜0.05). Conclusion Hysteroscopic shaving system can effectively improve the treatment effect, has small impact on ovarian function, and reduce the postoperative recurrence rate.

关键词

宫腔镜下刨削系统 / 电切术 / 子宫内膜息肉 / 并发症 / 复发

Key words

hysteroscopic shaving system / electrotomy / endometrial polyps / complications / recurrence

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