宫腔镜旋切与宫腔镜电切诊治子宫内膜息肉效果及生殖预后  

Effect and reproductive prognosis of the hysteroscopic intrauterine bigatti shave and hysteroscopic electricity resection for treating endometrial polyps of patients

作　　者：麦月施 陈美君 周叶[1] 徐川微 邢秀月 李晓丽[1] 王丽娜[1] MAI Yueshi;CHEN Meijun;ZHOU Ye;XU Chuanwei;XING Xiuyue;LI Xiaoli;WANG Lina(Qionghai People's Hospital,Qionghai,Hainan Province,571400)

机构地区：[1]海南省琼海市人民医院,571400

出　　处：《中国计划生育学杂志》2024年第4期898-902,共5页Chinese Journal of Family Planning

基　　金：海南省自然科学基金青年基金项目(821QN1008)。

摘　　要：目的:探讨宫腔镜旋切术系统(IBS)与宫腔镜电切术(TCR)治疗子宫内膜息肉(EPs)的临床效果、安全性以及生殖预后。方法:回顾性收集2019年4月-2021年4月本院收治的EPs患者330例临床资料,根据手术方式分为宫腔镜息肉旋切术(IBS组)114例,电切术(TCR组)216例,比较两组手术相关情况、术后月经复潮时间,术后1、6、12月子宫内膜恢复情况,手术结局(治愈、未愈、宫腔粘连、自然妊娠、复发)。结果:IBS组手术时间(9.5±1.3min)短于TCR组(13.1±1.2min),术中宫腔液体灌注量(2265±19ml)少于TCR组(3305±32ml)(均P<0.05),两组术中出血量、术中并发症、住院时间无差别(P>0.05)。IBS组术后钠离子(138.88±0.130 mmol/L)高于TCR组(138.23±0.280 mmol/L)(P<0.05),两组术后钾离子、钙离子、血红蛋白均无差别(P>0.05)。术后随访,两组术后1月阴道彩超提示均治愈,且卵泡期子宫内膜厚度无差别(P>0.05),IBS组术后6个月、12个月卵泡期子宫内膜厚度(6.6±0.2mm、6.8±0.2mm)较TCR组厚(5.7±0.1mm、6.2±0.2mm),术后自然妊娠率(66.6%)高于TCR组(29.6%)(P<0.05)。两组术后均未见明显宫腔粘连,术后1年复发率TCR组(0)与IBS组(3.2%)无差异(P>0.05)。结论:宫腔镜旋切术治疗EPs具有手术时间短,术后子宫内膜修复快,受孕率高等优点,因一定程度避免电热能对子宫内膜的损伤,故提高了对子宫内膜的保护程度。Objective:To investigate the clinical effect,safety and reproductive prognosis of the hysteroscopic intrauterine bigatti shave(IBS)and hysteroscopic electricity resection(HEC)for treating endometrial polyps(EPs)of patients.Methods:The clinical data of 330 patients with EPs who were treated in hospital from April 2019 to April 2021 were collected retrospectively.These patients were divided into group A(114 cases with the operative mode of IBS)and group B(216 cases with the operative mode of HEC)according to the different operative mode.The operation-related conditions,the postoperative menstrual rehydration time,the postoperative endometrial recovery situation in 1,6,and 12 months after surgery,and the surgery outcomes,such as healed,unhealed,intrauterine adhesions,spontaneous pregnancy and recurrence of Eps of the patients were compared between the two groups.Results:The operation time(9.5±1.3min)of the patients in group A was significantly shorter than that(13.1±1.2min)of the patients in group B,and the intraoperative uterine fluid perfusion(2265±19ml)of the patients in group A was significantly less than that(3305±32ml)of the patients in group B(all P<0.05).There were no significant differences in the intraoperative blood loss,the intraoperative complications rate and the duration of hospital stay of the patients between the two groups(P>0.05).The postoperative sodium level(138.88±0.130mmol/L)of the patients in group A was significantly higher than that(138.23±0.280 mmol/L)of the patients in group B(P<0.05).There was no significant difference in the levels of postoperative potassium,calcium and hemoglobin of the patients between the two groups(P>0.05).The results of the postoperative follow-up showed that the patients in the two groups were cured that evaluated by vaginal color Doppler ultrasound in 1 month after operation.There was no significant difference in the endometrial thickness of the patients during follicular phase between the two groups(P>0.05).The endometrial thickness of the patients in grou

关 键 词：子宫内膜息肉 宫腔镜旋切术 宫腔镜电切术 术后复发 术后妊娠 

分 类 号：R713.4[医药卫生—妇产科学]