宫腔镜下息肉电切术对子宫内膜息肉合并不孕症患者的临床疗效、复发及术后妊娠结局的影响  

Effects of Hysteroscopes-guide Transcervical Resection of Polyps under Hysteroscope on Clinical Efficacy,Recurrence and Postoperative Pregnancy Outcome in Patients with Endometrial Polyps Associated by Infertility

作　　者：李燕华[1] 何玮[1] 吴小芳 李秀泽[1] LI Yan-hua;HE Wei;WU Xiao-fang;LI Xiu-ze(Department of Obstetrics and Gynecology,Mianyang Central Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]绵阳市中心医院妇产科,四川绵阳621000

出　　处：《解放军医药杂志》2019年第2期72-75,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省卫生和计划生育委员会科研课题(17PJ232)

摘　　要：目的观察宫腔镜下子宫内膜息肉电切术(TCRP)治疗子宫内膜息肉(EP)伴不孕症的临床疗效,对复发和妊娠结局的影响。方法选取我院在2015年1月—2016年11月收治的EP伴不孕82例,按手术方法分为观察组和对照组,每组41例。观察组给予TCRP,对照组给予宫腔镜下刮宫术;观察2组围手术期指标、术后月经量,术后1年复发及妊娠情况。结果 2组手术时间、术中出血量、住院时间和围手术期并发症比较差异无统计学意义(P>0. 05)。2组术后月经量较术前减少,且术后3个观察组月经量少于对照组(P <0. 05)。观察组术后6个月复发率低于对照组,术后6～12个月内妊娠成功率高于对照组(P <0. 05)。结论宫腔镜子宫内膜息肉电切术治疗EP合并不孕症疗效显著,可改善患者月经情况,降低复发率,促进再孕。Objective To observe clinical efficacy of hysteroscopes-guide transcervical resection of polyps(TCRP)in treatment of patients with endometrial polyps(EP)associated by infertility and to evaluate effects of recurrence and pregnancy outcome.Methods A total of 82 EP patients with infertility admitted during January 2015 and November 2016 were divided into observation group and control group(n=41 for each group)according to operative methods.Observation group was given TCRP surgery,while control group was treated with hysteroscopes-guide uterine curetlage.In two groups,perioperative indexes,postoperative menstrual blood volume,conditions of recurrence and pregnancy in 1 year after surgery were observed.Results There were no significant differences in operative time,intraoperative blood loss,hospital stay and incidence rate of peroperative complications between two groups(P >0.05).Menstruation volumes after surgery were significantly less than those before surgery in two groups,and the volumes in 3 rd month after surgery in observation group was significantly less than that that in control group(P<0.05).In observation group recurrence rate in 6 th after surgery was significantly lower.while pregnancy success rate from 6 th month to 12 th month after surgery was significantly higher than those in control group(P<0.05).While the positive rates of VEGF and TGF-βafter treatment were significantly lower than those in control group(P<0.05).Conclusion Hysteroscopes-guide TCRP in treatment of patients with EP associated by infertility may improve menstruation condition,reduce recurrence rate and promote re-pregnancy.

关 键 词：不孕症 宫腔镜外科手术 子宫内膜病 息肉 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]