摘要
目的:观察不同手术方式对子宫内膜息肉(EP)不孕患者性生活质量及妊娠结局的影响。方法:回顾性分析2017年5月至2018年8月我院106例EP不孕患者,依据手术方案分组,每组各53例。钳夹组:行宫腔镜下息肉钳夹术机械性清除,电切组:行宫腔镜子宫内膜息肉电切除术。对比两组手术前后子宫内膜厚度、月经失血图(PBAC)评分、宫腔液细胞因子[白细胞介素-1β(IL-1β)、干扰素γ(IFN-γ)、胰岛素样生长因子-1(IGF-1)]水平、性生活质量、随访1年复发率及妊娠结局。结果:子宫内膜厚度、PBAC评分:电切组术后3个月子宫内膜厚度小于钳夹组,PBAC评分低于钳夹组(P<0.05);宫腔液细胞因子:电切组术后3个月宫腔液IL-1β、IFN-γ、IGF-1水平低于钳夹组(P<0.05);性生活质量:电切组术后6个月性生活满意度、每周性生活频率高于钳夹组,性唤起时间短于钳夹组,获得高潮时间长于钳夹组(P<0.05);复发率:电切组术后9、12个月复发率低于钳夹组(P<0.05);妊娠结局:术后随访12个月,电切组宫内妊娠率(74.51%)高于钳夹组(52.00%)(P<0.05)。结论:与宫腔镜下息肉钳夹术机械性清除相比,宫腔镜子宫内膜息肉电切除术能显著改善EP不孕患者子宫内膜厚度,降低月经量,提高性生活质量和宫内妊娠率,且安全性较高。
Objective:To observe the effect of different surgical methods on the quality of sexual life and pregnancy outcome of infertile patients with endometrial polyp(EP).Methods:A retrospective analysis was made,involving 106 EP infertility patients having hospitalized from May 2017 to August 2018 who were grouped according to the surgical protocol,53 cases in each of the clamping group and the resection group.The clamping group demanded mechanical removal with hysteroscopic polyp clamp and the resection group demanded hysteroscopic endometrial polypectomy through electrosurgical.Endometrial thickness,menstrual hemorrhage map(PBAC)score,intrauterine cytokines[interleukin-1β(IL-1β),interferon gamma(IFN-γ),insulin-like growth factor-1(IGF-1)]level,quality of sexual life,recurrence rate at one year follow-up,and pregnancy outcome were compared between the two groups before and after surgery.Results:Three months after operation,the resection group was reported with the endometrial thickness smaller and the PBAC score lower than clamping group(P<0.05);Cytokines in the uterine fluid:Three months after operation,the resection group was reported with levels of IL-1β,IFN-γ,and IGF-1 in the uterine fluid lower than clamping group(P<0.05);Quality of sexual life:six months after operation,the resection group reported higher sexual satisfaction and weekly frequency of sexual life,shorter sexual arousal time and longer orgasm duration than clamping group(P<0.05);Recurrence rate:Nine and twelve months after operation,the resection group reported lower recurrence rate than the clamping group(P<0.05);Outcome of pregnancy:After 12 months of follow-up,the intrauterine pregnancy rate in the resection group(74.51%)was higher than that in the clamping group(52.00%)(P<0.05).Conclusion:Compared with hysteroscopic polypectomy,hysteroscopic endometrial polypectomy can significantly improve the endometrial thickness of EP infertile patients,reduce menstrual volume,improve the quality of sexual life and intrauterine pregnancy rate,and has hig
作者
刘晶晶
张晓光
袁凤云
LIU Jingjing;ZHANG Xiaoguang;YUAN Fengyun(Bozhou People's Hospital,Anhui Bozhou 236800,China)
出处
《河北医学》
CAS
2020年第5期863-868,共6页
Hebei Medicine
基金
安徽省卫生厅科研课题,(编号:17HA01286)。
