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目的探讨宫腔镜下电切术与刮宫术对子宫内膜息肉不孕的疗效。方法收集2012年6月至2015年6月接受诊治的子宫内膜息肉不孕患者180例为研究对象,按照随机数字表法分成A组和B组,每组90例。A组患者行宫腔镜下电切术治疗,B组患者行宫腔镜下刮宫术治疗。记录所有患者本次手术时间、患者手术失血量、住院天数等围手术期指标;患者手术前、手术后1个月、半年、1年时月经情况;患者经手术治疗1年后复发情况以及妊娠情况;免疫组化法检测治疗前后子宫内膜组织VEGF和TGF-β的表达情况。结果 2组患者手术时间、术中失血量、住院天数等围手术期指标比较,差异无统计学意义(P>0.05)。A组患者复发率显著低于B组,妊娠率显著高于B组(P<0.05)。治疗前,A组月经量与B组比较,差异无统计学意义(P>0.05)。治疗1个月、半年、1年后,A组月经量显著低于B组(P<0.05)。治疗前A、B 2组患者VEGF、TGF-β阳性率比较差异无统计学意义(P>0.05),治疗后,A组阳性率显著低于B组(P<0.05)。结论宫腔镜下电切术治疗子宫内膜息肉不孕较刮宫术比较,疗效更优、复发率更低、妊娠率更高,其机制可能与显著降低子宫内膜组织VEGF、TGF-β的表达有关。
Objective To investigate the effect of hysteroscopic resection and curettage on endometrial polyps infertility. Methods A total of 180 cases of infertility with endometrial polyps who underwent diagnosis and treatment between June 2012 and June 2015 were enrolled and divided into A group and B group according to the random number table method, with 90 cases in each group. A group of patients underwent hysteroscopic resection, B group underwent hysteroscopic curettage. All patients underwent operation such as operation time, blood loss and length of hospitalization, and other perioperative indexes. Preoperative, postoperative 1 month, 6 months, 1 year menstrual period; 1 year after surgery, pregnancy and pregnancy The immunohistochemical method was used to detect the expression of VEGF and TGF-β in endometrial tissue before and after treatment. Results There was no significant difference in perioperative indexes between the two groups in operation time, intraoperative blood loss and hospitalization days (P> 0.05). The recurrence rate in group A was significantly lower than that in group B, and the pregnancy rate was significantly higher than that in group B (P <0.05). Before treatment, the menstrual flow in group A was not significantly different from that in group B (P> 0.05). After treatment for 1 month, 6 months and 1 year, the menstrual flow in group A was significantly lower than that in group B (P <0.05). The positive rates of VEGF and TGF-β in group A and group B before treatment were not significantly different (P> 0.05). After treatment, the positive rate of group A was significantly lower than that of group B (P <0.05). Conclusion Hysteroscopic resection of endometrial polyps of infertility compared with curettage, better efficacy, lower recurrence rate, higher pregnancy rate, the mechanism may be significantly lower endometrial VEGF, TGF-β Expression related.