不同病理分型子宫肌瘤患者宫腔镜术后复发率及生殖预后的影响  

Effects of recurrence rate and reproductive prognosis in patients with different pathological types of uterine fibroids after hysteroscopy

作　　者：李宁 谢青宁 张小荣[1] 聂仕刚 何明祥[3] LI Ning;XIE Qing-ning;ZHANG Xiao-rong(Department of Gynecology,People's Hospital of Chongqing Shapingba District,Chongqing 400030,China)

机构地区：[1]重庆市沙坪坝区人民医院妇科,重庆400030 [2]重庆市沙坪坝区人民医院产科,重庆400030 [3]重庆医科大学附属第一医院产科,重庆400016

出　　处：《临床和实验医学杂志》2020年第24期2657-2660,共4页Journal of Clinical and Experimental Medicine

基　　金：重庆市卫生局医学科研项目(编号:2013-2-200)。

摘　　要：目的探究不同病理分型子宫肌瘤患者宫腔镜术后复发率及生殖预后的影响。方法回顾性分析2015年7月至2017年9月重庆市沙坪坝区人民医院妇科诊治的88例行宫腔镜术子宫肌瘤患者病例资料。根据病理分型分为0型组26例,Ⅰ型组34例,Ⅱ型组28例。患者均接受宫腔镜电切电凝术。观察3组患者手术指标、术后并发症,随访3个月后肌瘤残留、随访6个月后肌瘤复发率、再次手术率,随访2年生殖结局。结果与0型、Ⅰ型组比较,Ⅱ型组手术时间、术后住院时间较长,术中出血量较多,差异有统计学意义(P<0.05)。Ⅱ型组术后并发症发生率高于0型组和Ⅰ型组,Ⅰ型高于0型组,差异有统计学意义(P<0.05)。Ⅱ型组和Ⅰ型组3个月后肌瘤残留率、6个月后复发率、再次手术率高于0型组,差异有统计学意义(P<0.05)。与无肌瘤残留、复发患者比较,0型组、Ⅰ型组及Ⅱ型组术后肌瘤残留、复发患者妊娠率、足月分娩率均较低;Ⅰ型组妊娠率、足月分娩率低于0型组,高于Ⅱ型组,差异有统计学意义(P<0.05)。结论Ⅱ型子宫肌瘤患者行宫腔镜术后肌瘤残留率和复发率均高于0型和Ⅰ型子宫肌瘤,对生殖预后产生不利影响,故要求有生育需求患者选择其他治疗方式,提高预后及生殖水平。Objective To explore the effect of recurrence rate and reproductive prognosis in patients with different pathological types of uterine fibroids after hysteroscopy.Methods From July 2015 to September 2017,88 patients with uterine fibroids by hysteroscopic surgery diagnosed and treated in People's Hospital of Chongqing Shapingba District were enrolled for retrospective analysis.According to the classification of cases,they were divided into 26 cases in type 0 group,34 cases in type Ⅰ group and 28 cases in type Ⅱ group.All patients underwent hysteroscopic surgery and electrocoagulation.The operation indexes and postoperative complications of the three groups of patients,the residual of fibroids after 3 months of follow-up,the recurrence rate of myomas after 6 months,the reoperation rate,and the reproductive outcome of 2 years of follow-up were recorded.Results Compared with the type 0 group and type I group,the type II group had longer operation time,longer postoperative hospital stay,and more intraoperative blood loss(P<0.05).The incidence of postoperative complications in typeⅡgroup was higher than that in type 0 group and typeⅠgroup,and typeⅠwas higher than type 0 group(P<0.05).The residual rate of fibroids,relapse rate and reoperation rate after 3 months in typeⅡgroup and typeⅠgroup were higher than those in type 0 group(P<0.05).Compared with the patients without residual or recurrent myoma,the pregnancy rate and full-term delivery rate of type 0,typeⅠand typeⅡgroups were lower;the pregnancy rate and full-term delivery rate of typeⅠgroup were lower than that of type 0 group and higher than that of typeⅡgroup,with significant difference(P<0.05).Conclusion The residual rate and recurrence rate of myoma in patients with type Ⅱ uterine fibroids after hysteroscopy are higher than type 0 and type Ⅰ uterine fibroids,which has a negative impact on the reproductive prognosis.Therefore,it is required that patients with reproductive needs choose other treatment methods to improve the prognosis and

关 键 词：子宫肌瘤 病理分型 宫腔镜 复发率 生殖预后 

分 类 号：R737.33[医药卫生—肿瘤]