宫腔镜下不同手术方式联合左炔诺孕酮宫内节育系统治疗子宫内膜息肉的效果及复发情况观察  

Observation on the effect and recurrence condition of different surgical methods under hysteroscopy combined with levonorgestrel intrauterine system in treating endometrial polyps

作　　者：冯琴琴 许琳玲 黄俊杰 姚荣华 陶冉 FENG Qinqin;XU Linling;HUANG Junjie;YAO Ronghua;TAO Ran(Department of Obstetrics and Gynecology,the 901st Hospital of the Joint Logistics Support Force of the People′s Liberation Army of China,Hefei 230031,Anhui,China)

机构地区：[1]中国人民解放军联勤保障部队第九○一医院妇产科,合肥230031

出　　处：《中国性科学》2025年第2期43-46,共4页Chinese Journal of Human Sexuality

基　　金：2022年安徽省重点研究与开发计划项目(2022e07020052)。

摘　　要：目的探究宫腔镜下不同手术方式联合左炔诺孕酮宫内节育系统治疗子宫内膜息肉的效果及复发情况。方法回顾性分析2022年1月至2024年1月中国人民解放军联勤保障部队第九○一医院收治的112例子宫内膜息肉患者,根据不同手术方式分为刮宫组与电切组,各56例。对比两组临床疗效、手术相关指标、并发症发生情况、手术前后子宫内膜厚度和性激素水平变化及复发率。结果电切组总有效率显著高于刮宫组(P<0.05);电切组手术时间、住院时间及月经恢复正常时间均显著短于刮宫组,术中出血量少于刮宫组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);术后3、6、12个月,两组子宫内膜厚度先下降后上升,且各时间段电切组均显著低于刮宫组(P<0.05);术后3、6、12个月,两组性激素水平均下降(P<0.05),且电切组各时间点均显著低于刮宫组(P<0.05);电切组复发率显著低于刮宫组(P<0.05)。结论宫腔镜下电切术与刮宫术联合左炔诺孕酮宫内节育系统均可有效治疗子宫内膜息肉,电切术在改善卵巢功能、预防复发方面更具优势。Objective To explore the effect and recurrence condition of different surgical methods under hysteroscopy combined with levonorgestrel intrauterine system in the treating endometrial polyps.Methods A retrospective analysis was performed on 112 patients with endometrial polyps admitted to the 901 st Hospital of the Joint Logistics Support Force of the People′s Liberation Army of China from January 2022 to January 2024.According to different surgical methods,the patients were classified into curettage group and electrotomy group,with 56 patients in each of the two groups.The clinical efficacy,surgery-related indicators,occurrence of complications,endometrial thickness and sex hormones levels before and after surgery,and recurrence rate of the two groups were compared.Results The total efficacy in the electrotomy group was significantly higher than that in the curettage group(P<0.05).The surgical time,hospital stay and menstrual recovery time in the electrotomy group were significantly shorter than those in the curettage group,and the intraoperative blood loss volume was less than that in the curettage group(P<0.05).There were no statistically significant difference in the incidence of complications between the two groups(P>0.05).At 3,6 and 12 months after surgery,the endometrial thickness in the two groups was decreased first and then increased,and the thickness in the electrotomy group at each time period was significantly thinner than that in the curettage group(P<0.05).The levels of sex hormones in both groups both were decreased at 3,6 and 12 months after surgery(P<0.05),and the levels at each time point in the electrotomy group were significantly lower than those in the curettage group(P<0.05).The recurrence rate in the electrotomy group was significantly lower compared to that in the curettage group(P<0.05).Conclusions Hysteroscopic electrotomy and curettage combined with levonorgestrel intrauterine system can both effectively treat endometrial polyps.Electrotomy has more advantages in improving ovarian fun

关 键 词：宫腔镜电切术 宫腔镜刮宫术 子宫内膜息肉 左炔诺孕酮宫内节育系统 

分 类 号：R711[医药卫生—妇产科学]