宫腔镜子宫纵隔冷刀手术与电切术对子宫内膜影响的对比研究  

Comparative Study on Endometrium Reepithelialization after Surgery of Uterine Septum Using Hysteroscopic Scissors and Resectoscope

作　　者：马宁[1] 黄晓武[1] 周巧云[1] 杨玲玲[1] 夏恩兰[1] 

机构地区：[1]首都医科大学附属复兴医院宫腔镜中心,北京100038

出　　处：《国际生殖健康／计划生育杂志》2017年第3期204-207,265,共5页Journal of International Reproductive Health/Family Planning

基　　金：首都医科大学基础-临床科研合作项目(16JL62)

摘　　要：目的:观察子宫纵隔冷刀手术与电切手术术后宫腔创面的愈合过程,探讨不同手术方式对子宫内膜的影响。方法:选择2015年1月—2016年12月在首都医科大学附属复兴医院宫腔镜中心就诊的不全子宫纵隔患者60例,随机分为宫腔镜下冷刀组(30例)和电切组(30例),记录一般资料及术中情况,包括手术时间、出血量、并发症等。分别于术后1和2个月行宫腔镜检查,观察和比较2组宫腔创面的子宫内膜上皮化过程、宫腔粘连、残隔等情况。结果:冷刀组的手术时间比电切组更短,差异有统计学意义[(13.90±3.95)min vs.(23.13±5.15)min,P=0.00],冷刀组与电切组出血量比较差异无统计学意义[(8.67±2.25)m L vs.(8.83±2.15)m L,P=0.77]。2组术中均未发生并发症,术后均未发现残隔或宫腔粘连。术后1个月,冷刀组较电切组内膜上皮不满意者更少,差异有统计学意义[16.67%(5/30)vs.93.33%(28/30),P=0.00];术后2个月2组宫腔创面内膜上皮化均良好,无不满意情况发生。2组均未发现宫腔粘连及残隔。结论:子宫纵隔切除术后1个月冷刀组子宫内膜上皮化过程更快,术后2个月2组创面全部愈合。Objective： To evaluate the clinical outcomes of endometrial reepithelialization betweenhysteroscopic scissors and resectoscope in those patients underwent transcervical resection of septum （TCRS）. Methods： This is a randomized controlled study including 60 women with partial septate uterus, in our center from January 2015 to December 2016. Thirty cases underwent hysteroscopic metroplasty using hysteroscopic scissors （group A） and 30 cases had the procedure using the bipolar electrodes （group B）. Main characteristics of the patients and operative parameters （operative time, blood loss, complications） were recorded. The hysteroscopic examination was performed after 1 and 2 months of surgery to evaluate the endometrial healing process including endometrial reepithelialization, intrauterine adhesions and residual suptum. Results： Although the operating time in the group A was significantly faster than that in the group B [（13.90±3.95） min vs. （23.13±5.15） min,P=0.00], there was no significant difference in the blood loss between the 2 groups [（8.67±2.25） mL vs. （8.83±2.15） mL, P= 0.77]. There were not any intraoperative complications in two groups, and intrauterine adhesion or residual septum in two months follow-up visit. The poor reepithelialization in the group A was less than that in the group B [16.67% （5/30） vs. 93.33% （28/30）, P=0.00], in the 1 month,s visit. However, the endometrium reepithelialization was completely satisfied in two groups after surgery. Conclusions： The endometrial reepithelialization is faster in the scissors group than that in the resectoscope group in the first month after surgery. However, the epithelialization status can be well satisfied in two groups within 2 months.

关 键 词：子宫 纵隔 宫腔镜 外科手术 微创性 子宫内膜 

分 类 号：R713.4[医药卫生—妇产科学]