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目的探究宫腔镜电切术治疗子宫内膜息肉的手术要点与治疗效果,为治疗方案的选择提供科学依据。方法 147例子宫内膜息肉患者,依据患者意愿分为两组,电切组82例,给予宫腔镜电切术治疗;刮宫组65例,患者给予宫腔镜下刮宫术治疗。随访6~9个月并记录两组手术要点、手术时间、术中出血量、术后1 d出血量、平均住院时间、月经量、并发症及复发率等情况并比较分析。结果电切组患者手术时间稍长于刮宫组,术中出血量及术后1 d出血量两组患者差异无统计学意义(P>0.05),但刮宫组患者平均住院时间短于电切组。在随访中发现,电切组恢复月经较早,且月经量显著少于刮宫组;电切组并发症发生率及复发率分别为0和1.22%低于剖宫组7.69%和6.15%,差异有统计学意义(P<0.05)。结论宫腔镜电切术治疗子宫内膜息肉具有直视下手术可切除息肉根部,并发症低及复发率低等优点,应为临床首选治疗方案。
Objective To explore the operative points and therapeutic effects of hysteroscopic resection for endometrial polyps and to provide a scientific basis for the selection of treatment options. Methods A total of 147 cases of endometrial polyps were divided into two groups according to the patients’ wishes. The patients in the resection group were treated by hysteroscopic electrotomy. In the curettage group, 65 cases were treated with hysteroscopic curettage. The patients were followed up for 6 to 9 months and the operative points, operation time, intraoperative blood loss, postoperative 1 day bleeding, average length of stay, menstrual flow, complications and recurrence were recorded and compared. Results The operation time of the patients in the resection group was slightly longer than those in the curettage group. There was no significant difference between the two groups in the amount of blood loss and the postoperative 1 day bleeding (P> 0.05). However, the average length of hospital stay in the patients with curettage group was shorter than that in the resection group. At follow-up, it was found that the resection group had earlier menstruation and less menstrual flow than the curettage group. The incidence of complications and recurrence rates in the resection group were 0 and 1.22%, respectively, lower than 7.69% and 6.15% in the cesarean section group There was statistical significance (P <0.05). Conclusion Hysteroscopic resection of endometrial polyps with direct vision surgery can remove the roots of polyps, low complications and low recurrence rate should be the preferred clinical treatment options.