宫腔镜下冷刀切除术在内突型肌壁间子宫肌瘤患者中的应用价值  

Application value of hysteroscopic cold knife resection in patients with intramural uterine fibroids

作　　者：田芳芳 邵世清[2] 李盼盼 Tian Fang-fang;Shao Shi-qing;Li Pan-pan(Department of Gynecology and obstetrics,Qixian People's Hospital,Qixian County,Kaifeng 475200,Henan,China;Department of Gynecology,Huaihe Hospital,Henan University,Kaifeng 475000,Henan,China;Department of Ultrasound,Huaihe Hospital,Henan University,Kaifeng 475000,Henan,China)

机构地区：[1]杞县人民医院妇产科,开封杞县475200 [2]河南大学淮河医院妇科,河南开封475000 [3]河南大学淮河医院超声科,河南开封475000

出　　处：《四川生理科学杂志》2025年第2期247-249,458,共4页

基　　金：河南省医学科技攻关联合共建项目(编号:LHGJ20216733)。

摘　　要：目的:探讨宫腔镜下冷刀切除术在内突型肌壁间子宫肌瘤(Uterinemyoma,UM)患者中的应用价值。方法:选取杞县人民医院2021年1月至2022年12月收治的内突型肌壁间UM患者196例,随机分为电刀组和冷刀组,各98例。电刀组行宫腔镜下电刀切除术,冷刀组行宫腔镜下冷刀切除术。比较两组手术相关指标(术中总失血量、手术用时、住院天数);电化学发光法检测术前及术后3 m黄体生成素(Luteinizing hormone,LH)、卵泡刺激素(Follicle stimulating hormone,FSH)、雌二醇(Estradiol,E_(2));比较两组术后1 m、术后3 m及术后6 m肌层愈合情况、术后12m妊娠率和复发率。结果:冷刀组术中总失血量少于电刀组,手术用时和住院天数短于电刀组(P<0.05);术后3m,冷刀组LH、FSH水平低于电刀组,E_(2)水平高于电刀组(P<0.05);术后1m、3m及6 m,冷刀组肌层愈合率均高于电刀组(P<0.05);术后12m,冷刀组妊娠率高于电刀组(P<0.05),但复发率与电刀组比较,无明显差异(P>0.05)。结论:与电刀切除术比较,宫腔镜下冷刀切除术治疗内突型肌壁间UM患者,可缩短手术用时,减少术中总失血量,缩短康复进程,对卵巢功能的影响较小,肌层愈合较快,可进一步提升妊娠率。Objective:To evaluate the clinical value of hysteroscopic cold knife resection in patients with intramural uterine myoma(UM).Methods:A total of 196 patients with intramural UM treated in Qixian People's Hospital from Jan.2021 to Dec.2022 were collected and randomly divided into electric knife group and cold knife group,98 cases in each group.Hysteroscopic electrosurgical resection was performed in the electric knife group and hysteroscopic cold knife resection was performed in the cold knife group.The indexes related to surgery(total intraoperative blood loss,operation time,hospital stay)were compared between the two group;luteinizing hormone(LH),follicle stimulating hormone(FSH)and estradiol(E_(2))were detected by electrochemiluminescence method before and after 3 months of surgery;muscle healing after 1 month,3 months and 6 months of surgery,pregnancy rate and recurrence rate after 12 months of surgery were compared between the two groups.Results:The total intraoperative blood loss in the cold knife group was less than that in the electric knife group,and the operation time and hospitalization days were shorter than those in the electric knife group(P<0.05).After 3 months of surgery,LH and FSH levels in cold knife group were lower than those in electric knife group,and E_(2) level was higher than that in electric knife group(P<0.05).After 1 month,3 months and 6 months of surgery,the muscle healing rate in cold knife group was higher than that in electric knife group(P<0.05).Aftert 12 months of surgery,the pregnancy rate in the cold knife group was higher than that in the electric knife group(P<0.05),but there was no significant difference in the recurrence rate between the cold knife group and the electric knife group(P>0.05).Conclusion:Compared with electrosurgical resection,hysteroscopic cold knife resection can shorten the operation time,reduce the total intraoperative blood loss,shorten the rehabilitation process,have less impact on ovarian function,and faster muscle healing,which can further improve the pr

关 键 词：内突型肌壁间子宫肌瘤 宫腔镜 冷刀切除术 

分 类 号：R71[医药卫生—妇产科学]