宫腹腔镜联合治疗子宫内膜异位症合并内膜息肉患者的临床效果及安全性  

Clinical Effect and Safety of Hysteroscopy Combined with Laparoscopy in the Treatment of Endometriosis Complicated with Endometrial Polyps

作　　者：张璐[1] ZHANG Lu(Department of Obstetrics and Gynecology,Tianjin First Central Hospital,Tianjin 300010,China)

机构地区：[1]天津市第一医院妇产科,天津300010

出　　处：《医学信息》2025年第5期140-143,共4页Journal of Medical Information

摘　　要：目的研究子宫内膜异位症合并内膜息肉患者应用宫腹腔镜联合治疗的临床效果及安全性。方法将我院2010年3月-2022年3月诊治的48例子宫内膜异位症合并内膜息肉患者依据随机数字表法分为对照组和观察组,各组24例。对照组行腹腔镜手术治疗,观察组行宫腹腔镜联合手术治疗,对两组临床手术指标、子宫内膜厚度、子宫内膜异位症生育指数(EFI)、性激素指标水平[血清促黄体生成素(LH)、促卵细胞激素(FSH)]、妊娠率、复发率进行比较。结果与对照组比较,观察组手术时间更短,且术中出血量更少、术后肛门排气时间更短(P<0.05);与对照组术后3、6个月子宫内膜厚度比较,观察组术后3、6个月子宫内膜厚度更小(P<0.05);与术前比较,两组术后EFI升高,且与对照组比较,观察组术后EFI更高(P<0.05);与术前比较,两组术后LH水平降低,FSH水平升高,且与对照组比较,观察组术后LH水平更低,FSH水平更高(P<0.05);随访1年,与对照组自然妊娠率(29.17%)、复发率(25.00%)比较,观察组自然妊娠率更高(41.67%),复发率更低(4.17%)(P<0.05)。结论宫腹腔镜联合治疗子宫内膜异位症合并内膜息肉可改善临床手术指标,减小子宫内膜厚度,提高EFI指数,降低LH和FSH水平,提高1年内自然妊娠率,降低1年内复发率,具有良好的治疗疗效及安全性。Objective To study the clinical effect and safety of hysteroscopy combined with laparoscopy in the treatment of endometriosis complicated with endometrial polyps.Methods A total of 48 patients with endometriosis complicated with endometrial polyps diagnosed and treated in our hospital from March 2010 to March 2022 were divided into control group and observation group according to the random number table method,with 24 patients in each group.The control group was treated with laparoscopic surgery,and the observation group was treated with hysteroscopy combined with laparoscopy.The clinical operation indexes,endometrial thickness,endometriosis fertility index(EFI),sex hormone index levels[serum luteinizing hormone(LH),follicle stimulating hormone(FSH)],pregnancy rate and recurrence rate were compared between the two groups.Results Compared with the control group,the operation time of the observation group was shorter,the intraoperative blood loss was less,and the postoperative anal exhaust time was shorter(P<0.05).Compared with the endometrial thickness of the control group at 3 and 6 months after operation,the endometrial thickness of the observation group was smaller at 3 and 6 months after operation(P<0.05).Compared with before operation,the EFI of the two groups increased after operation,and compared with the control group,the EFI of the observation group was higher after operation(P<0.05).Compared with before operation,the LH level decreased and the FSH level increased in the two groups after operation,while compared with the control group,the LH level was lower and the FSH level was higher in the observation group after operation(P<0.05).After 1 year of follow-up,compared with the natural pregnancy rate(29.17%)and recurrence rate(25.00%)of the control group,the natural pregnancy rate of the observation group was higher(41.67%)and the recurrence rate was lower(4.17%)(P<0.05).Conclusion Hysteroscopy combined with laparoscopy in the treatment of endometriosis with endometrial polyps can improve clinical surgical

关 键 词：宫腔镜 腹腔镜 子宫内膜异位症 内膜息肉 

分 类 号：R711.71[医药卫生—妇产科学]