宫腔镜电切术不同切除方法对Ⅱ型子宫黏膜下肌瘤患者术后宫腔粘连发生和妊娠结局的影响  

Effect of different methods of hysteroscopic electroresection on the occurrence of intrauterine adhesion and pregnancy outcome in patients with typeⅡsubmucosal myoma of uterus

作　　者：张春玲 ZHANG Chunling(Department of Gynecology,Yangjiang Maternal and Child Health Care Hospital,Guangdong Province,Yangjiang 529500,China)

机构地区：[1]广东省阳江市妇幼保健院妇科,广东阳江529500

出　　处：《中国当代医药》2022年第18期90-93,共4页China Modern Medicine

摘　　要：目的研究宫腔镜电切术不同切除方法对Ⅱ型子宫黏膜下肌瘤患者术后宫腔粘连发生率及妊娠结局的影响。方法选取2017年10月至2020年10月在阳江市妇幼保健院接受宫腔镜手术治疗的78例Ⅱ型子宫黏膜下肌瘤患者作为研究对象,采用随机数字表法将其分为试验组(n=39)和对照组(n=39)。试验组采用开窗后切除法,对照组采用直接切除法。比较两组患者的围手术期指标、随访指标、妊娠结局。结果两组患者的手术持续时间、术中出血量、膨宫液用量比较,差异无统计学意义(P>0.05)。术后1年内,两组患者的复发率比较,差异无统计学意义(P>0.05);术后1年内,两组患者的子宫肌层愈合率比较,差异无统计学意义(P>0.05);术后第1、6个月内,试验组子宫内膜创面愈合率高于对照组,差异有统计学意义(P<0.05);术后1年内,试验组宫腔粘连发生率低于对照组,差异有统计学意义(P<0.05)。术后1年内,试验组妊娠成功率高于对照组,差异有统计学意义(P<0.05)。结论宫腔镜电切术治疗Ⅱ型子宫黏膜下肌瘤患者中宜使用开窗后切除法,能促使患者术后子宫内膜创面快速愈合,预防术后宫腔粘连,提高妊娠成功率,对患者围手术期指标、子宫肌层愈合及术后复发率无影响,值得推广。Objective To study the effect of different resection methods of hysteroscopic electroresection on the incidence of intrauterine adhesion and pregnancy outcome in patients with typeⅡsubmucosal myoma of uterus.Methods A total of 78 patients with typeⅡsubmucosal myoma of uterus who underwent hysteroscopic surgery at Yangjiang Maternal and Child Health Care Hospital from October 2017 to October 2020 were selected as research objects,they were divided into experimental group(n=39)and control group(n=39)according to random number table method.The experimental group used the resection method after opening the window,and the control group used the direct resection method.The perioperative indicators,follow-up indicators and pregnancy outcome were compared between the two groups.Results There were no statistically significant differences in the operation duration,intraoperative blood loss and uterine dilatation fluid dosage between the two groups(P>0.05).There was no significant difference in the recurrence rate of the two groups within 1 year after operation(P>0.05).Within 1 year after the operation,the difference in the healing rate of the myometrium between the two groups was not statistically significant(P>0.05).At the 1st and 6th months after the operation,the endometrial wound healing rate in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).Within 1 year after surgery,the incidence of intrauterine adhesions in the experimental group was lower than that in the control group,the difference was statistically significant(P<0.05).Within 1 year after operation,the success rate of pregnancy in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Hysteroscopic electroresection after opening the window should be used in the treatment of typeⅡsubmucosal myoma of uterus.It can promote the rapid healing of endometrial wound,prevent postoperative intrauterine adhesion,and

关 键 词：宫腔镜电切术 Ⅱ型子宫黏膜下肌瘤 切除方法 宫腔粘连 妊娠结局 

分 类 号：R737.33[医药卫生—肿瘤]