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目的:探讨宫腔镜单极电切和双极汽化电切治疗子宫内膜息肉的疗效。方法:2005年6月～2010年6月在江西省妇幼保健院生殖健康科因子宫内膜息肉行宫腔镜息肉切除术患者共126例,分别于宫腔镜下行单极子宫内膜息肉切除+息肉旁浅层内膜切除术(A组,60例)、息肉切除+息肉旁浅层内膜汽化电切术(B组,66例)。结果:两组患者手术总时间差异无统计学意义(P>0.05),但电切时间A组为(5.9±1.5)min,明显短于B组的(7.8±2.1)min,器械进入宫腔的时间A组为(4.2±0.9)min,明显长于B组的(1.2±0.7)min,取标本时间A组为(2.6±2.1)min,明显短于B组的(3.5±3.3)min,A组患者术中舒适度VAS为2.1±0.5,明显高于B组的1.2±0.3,术后2 h及24 h舒适度VAS无明显差异。汽化电切时,多发性息肉或直径≥2 cm的息肉,或特殊部位的息肉明显延长电切时间,子宫前后壁及侧壁的息肉电切时间缩短,多发性息肉及较大息肉取标本的时间较其他类型息肉明显延长。结论:两种治疗子宫内膜息肉的手术方法均较简单、安全,完全切除率高,能获得较为满意的疗效,操作者较易掌握。但对于较大的息肉,或位于子宫底部输卵管开口周围的息肉,选择宫腔镜下单极电切术可以更有效地缩短手术时间。
Objective: To investigate the efficacy of hysteroscopic unipolar and bipolar vaporization in the treatment of endometrial polyps. Methods: From June 2005 to June 2010, a total of 126 patients underwent hysteroscopic polypectomy in reproductive health department of Reproductive and Child Health Hospital of Jiangxi Province from June, 2005 to June, 2010 were treated with hysteroscopic unipolar endometrial polypectomy + Polypsophageal shallow endarterectomy (A group, 60 cases), polyp resection + polyps near the shallow endometrial vaporization resection (B group, 66 cases). Results: There was no significant difference in the total operation time between the two groups (P> 0.05). However, the time of the resection in group A was (5.9 ± 1.5) min, which was significantly shorter than that in group B (7.8 ± 2.1) min. (4.2 ± 0.9) min in group A was significantly longer than that in group B (1.2 ± 0.7) min in group A, and (2.6 ± 2.1) min in group A was significantly shorter than that in group B (3.5 ± 3.3) min in group A The VAS in group A was 2.1 ± 0.5, significantly higher than that in group B (1.2 ± 0.3). There was no significant difference in VAS between 2 and 24 h after operation. Gastric electrosurgical resection, multiple polyps or polyps ≥ 2 cm in diameter, or special parts of the polyps significantly prolonged the cutting time, the uterus anteroposterior and lateral wall of the polyps cut shortening of time, multiple polyps and larger polyps specimens Time significantly longer than other types of polyps. Conclusion: The two surgical methods for the treatment of endometrial polyps are relatively simple, safe and complete resection rate, to obtain more satisfactory results, the operator easier to grasp. However, for larger polyps, or polyps located around the opening of the fallopian tube at the bottom of the uterus, hysteroscopic unipolar resection may be more effective in shortening the procedure.