摘要
目的:探讨分析宫腔镜下不同手术方式治疗子宫息肉的安全性和临床疗效,为临床疾病诊治提供一定理论依据。方法:研究对象为于2013年2月到2015年2月我院收治的子宫息肉需手术治疗的患者共165例,按入院时间先后随机分为A、B、C三组,每组各55例,其中A组行宫腔镜下刮匙定点刮除术,B组行宫腔镜直视下以环状电极电切息肉基底部,C组术式同B组,术后辅以安宫黄体酮治疗。观察三组患者手术时间、术中出血量、平均住院天数、术后异常出血例数、术后月经情况及随访患者疾病复发情况。结果:三组患者首诊时均经记录年龄及病程时长等一般情况,三组患者在年龄、病程、月经量、息肉数目及宫腔深度上相比均无明显差异(P均>0.05)。刮匙定点刮除术组患者手术时间平均为(19.9±1.2)min,术中出血量(33.8±2.4)mL,平均住院时间为(7.4±1.1)d;与其他两组相比,均明显偏大,差异有统计学意义(P<0.05)。术后密切关注所有患者病情,刮匙定点刮除术组患者阴道异常出血3例,发生术后闭经4例,术后月经减少8例。环切术组患者发生阴道异常出血1例,发生术后闭经2例,术后月经减少4例。辅以用药组患者发生阴道异常出血0例,发生术后闭经1例,术后月经减少1例。总的并发症发生率A组显著高于B、C组(P<0.05),而B、C两组之间比较差异无统计学意义。所有病例术后定期随访,术后1个月、3个月、6个月常规进行B超检查,结果显示三组复发人数分别为14例、2例和1例,刮匙定点刮除组复发率显著高于其他两组(P<0.05)。结论:宫腔镜下环状电极环切术及术后辅以药物治疗的方式治疗子宫内膜息肉优于宫腔镜下刮匙定点刮除术。
Objectives： To compare the effects of three methods for endometrial polyps,and provide certain theoretical basis for clinical disease diagnosis and treatment. Methods： 165 patients with endometrial polyps in our hospital from February 2013 to February 2015 were selected and,according to admission time,divided into three groups,group A,B and C,each group with 55 cases. Group A were treated by curet fixed- point curettage under hysteroscopy; group B were treated by annular electrode cutting polyps＇ base under hysteroscopy; group C received the same method with B,but provera after surgery. The operation time,intraoperative blood loss,average hospitalization days,abnormal bleeding after surgery cases,postoperative relapse of three groups were observed. Results：The patients＇ age and duration time was recorded at initial diagnosis. In general,there was no obvious difference in the general data between the three groups（ P〈0. 05）. In curet fixed- point curettage group,the average operation time was 19. 9 ± 1. 2（ min）; intraoperative blood loss was 33. 8 ± 2. 4（ ml）; the average length of hospital stay was7. 4 ± 1. 1（ d）. Compared with the other two groups,all were significantly increased,with statistically significant difference（ P〈0. 05）. In group A,there were 3 cases of postoperative abnormal vaginal bleeding,4 cases of postoperative amenorrhoea,and 8 cases of spanomenorrhea. In group B,there was 1 case of abnormal vaginal bleeding,2 cases of postoperative amenorrhoea,and 4 cases of spanomenorrhea. In group C,there was no case of abnormal vaginal bleeding,1 case of postoperative amenorrhoea,and 1 case of spanomenorrhea. Incidence of complications in group A was significantly higher than group B and C（ P〈0. 05）,while no significant difference was found between group B and group C. All patients received regular postoperative follow- up,and B ultrasound examination 1month,3 months and 6 months after. There were 14 cases,2 cases and 1 case of recurrence respectively in group A,B a
出处
《中国性科学》
2016年第6期35-37,共3页
Chinese Journal of Human Sexuality
关键词
子宫内膜息肉
宫腔镜
刮除术
环切术
Endometrial polyps
Hysteroscopy
Excochleation
Loop electrosurgical excision procedure
