宫腔镜下冷刀切术治疗子宫内膜息肉疗效及对血清炎症指标及妊娠影响  

Efficacy of hysteroscopic cold knife resection for treating patients with endometrial polyp and its influence on the serum inflammatory indexes levels and the pregnancy of the patients

作　　者：潘是郡 陈佩玉 万燕 PAN Shijun;CHEN Peiyu;WAN Yan(Huangshan Shoukang Hospital,Huangshan,Anhui Province,245000)

机构地区：[1]安徽省黄山首康医院,245000

出　　处：《中国计划生育学杂志》2023年第10期2338-2342,共5页Chinese Journal of Family Planning

摘　　要：目的:探究宫腔镜下冷刀切术治疗子宫内膜息肉(EP)疗效及对患者血清白介素(IL)-1β、IL-8水平及临床妊娠的影响。方法:随机数表法将本院2019年1月—2022年1月收治的86例EP患者分为冷刀组43例与电切组43例,分别接受宫腔镜下冷刀系统治疗与电切术。对比两组手术指标及并发症,测定术前、术后3个月月经量、子宫内膜厚度及血清IL-1β、IL-18水平;术后随访12个月,对比患者复发及妊娠结局。结果:冷刀组手术时间(21.3±5.8 min)、术中出血量(21.2±4.5 ml)及并发症总发生率(4.7%)均少于电切组(27.2±6.2 min、35.5±5.1 ml、23.3%),两组术后3个月月经失血图(PBAC)评分、子宫内膜厚度、血清IL-1β、IL-18水平均降低,且冷刀组PBAC评分(56.65±5.60分)、子宫内膜厚度(8.20±1.53mm)均大于电切组(52.61±5.73分、7.22±1.68 mm),血清IL-1β(6.20±1.75 pg/ml)、IL-18(30.19±5.34 pg/ml)水平均低于电切组(10.00±2.58 pg/ml、36.52±6.13 pg/ml)(均P<0.05);术后6个月、12个月复发率冷刀组(2.3%、7.0%)与电切照组(7.0%、14.0%)无差异(P>0.05);术后12个月临床妊娠率冷刀组(65.1%)高于电切组(41.9%)(P<0.05)。结论:宫腔镜下冷刀切术治疗EP安全有效,能明显降低术后患者血清IL-1β、IL-18水平,提高临床妊娠率。Objective:To investigate the efficacy of hysteroscopic cold knife resection for treating patients with endome-trial polyp(EP)and to study its influence on thelevels of serum interleukin(IL)-1βand IL-8,and the clinical preg-nancy situation of the patients.Methods:A total of 86 patients with EP were divided into two groups(43 cases in eachgroup)according to the random number table method from January 2019 to January 2022.The patients in the studygroupreceivedhysteroscopic coldknifesystematictreatment,and the patients in the control groupreceivedelectrotomytreatment.The surgical indexes and the complications rate of the patients were compared between the two groups.Themenstrual volume,the endometrial thickness,and the serum IL-1βand IL-18 levels of the patients in the two groupsbefore surgery and 3 months after surgery were measured.The situation of EPrecurrence and the pregnancy outcomesof the patients within 12 months of follow-up after surgery were compared between the two groups.Results:The oper-ation time(21.3±5.8 min),the intraoperative blood loss(21.2±4.5 ml),and the total complication rate(4.7%)ofthepatients in the studygroup were significantly lower than those(27.2±6.2min,35.5±5.1ml,and 23.3%)of thepatients in the control group.The menstrual blood loss map(PBAC)score,the endometrial thickness,and the serumIL-1g and IL-18 levels of the patients in both groups in 3 months after surgery had decreased significantly.The PBACscore(56.65±5.60 points)and the endometrial thickness(8.20±1.53mm)of the patients in the study group were significantly higher than those(52.61±5.73 points and 7.22±1.68mm)of the patients in the control group,but thelevels of serum IL-1p(6.20±1.75/ml)and IL-18(30.19±5.34 pg/ml)of thepatients in the studygroup were signifi-cantly lower than those(10.00±2.58 pg/ml and 36.52±6.13 pg/ml)of the patients in the control group(all P<0.05).The EP recurrence rate of the patients in 6 months(2.3%vs.7.0%)and in 12months(7.0%vs.14.0%)had nosignificantly different between the two groups(P>0.0

关 键 词：子宫内膜息肉 宫腔镜冷刀切术 白介素-1Β 白介素-18 炎症因子 妊娠结局 

分 类 号：R713.4[医药卫生—妇产科学]