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目的 :探讨子宫内膜息肉不孕症患者激素表达水平并比较分析宫腔镜电切除术与刮宫术的治疗效果。方法 :选取2015年1月~2016年12月我院收治的子宫内膜息肉不孕患者60例作为病例组对象,根据手术方式将病例组对象分为电切除术组(32例)和刮宫组(28例),另选取同期于我院就诊的宫腔正常但因其它因素而不孕的妇女40例作为对照组对象,检测各组雌激素受体(ER)和孕激素受体(PR),观察刮宫组、电切除术组术前、术后3个月、6个月、12个月的月经量变化以及两组术后1年内的复发率及妊娠率。结果 :各组在腺上皮细胞、间质细胞中ER的表达均无统计学差异;刮宫组及电切除术组在腺上皮细胞、间质细胞中PR的表达均显著低于对照组,差异有统计学意义。电切除术组术后3个月、6个月、12个月的月经量均少于术前,且少于同期对照组,差异有统计学意义;刮宫组术后3个月、6个月的月经量显著少于术前,术后12个月的月经量又恢复至术前水平。术后1年内刮宫组复发率为26.3%,显著高于电切除术组的复发率2.4%,差异有统计学意义;术后1年内刮宫组妊娠率为60.5%,电切除术组妊娠率为61.9%,两组之间无统计学差异。结论 :子宫内膜息肉与子宫内膜局部ER、PR表达失衡密切相关,宫腔镜下电切除术治疗子宫内膜息肉不孕症的效果较佳,该术式可长期改善并减少患者月经量,降低复发率,建议临床推广应用。
Objective: To investigate the expression of hormones in patients with endometrial polyps infertility and to analyze the therapeutic effect of hysteroscopic resection and curettage. Methods: From January 2015 to December 2016, 60 cases of endometrial polyps infertility admitted to our hospital from January 2015 to December 2016 were selected as the case group. According to the surgical methods, the patients were divided into two groups: electrosurgery group (32 cases) and curettage group (28 cases). Another 40 women with normal uterine cavity who were infertile due to other factors during the same period were selected as the control group. The levels of estrogen receptor (ER) and progesterone receptor (PR) , Observe the curettage group, resection group before surgery, 3 months after surgery, 6 months, 12 months of menstrual changes and the two groups within 1 year after the recurrence rate and pregnancy rate. Results: There was no significant difference in the expression of ER between glandular epithelial cells and mesenchymal cells in each group. The expression of PR in glandular epithelial cells and interstitial cells in the curettage group and the resection group was significantly lower than that in the control group Statistical significance. The electrosurgical group had less menstruation at 3 months, 6 months and 12 months after operation than those before operation and less than those in the control group at the same period. The curettage group had 3 months, 6 months Of the menstrual flow was significantly less than preoperative, postoperative 12-month menstrual volume and returned to the preoperative level. The recurrence rate of curettage group was 26.3% within 1 year after surgery, which was significantly higher than that of resection group (2.4%), the difference was statistically significant. The pregnancy rate in curettage group was 60.5% within 1 year after operation, and that in resection group was 61.9%, no significant difference between the two groups. Conclusion: Endometrial polyps and endometrial ER, PR expression imbalance is closely related to hysteroscopic resection of endometrial polyps of infertility better, the long-term surgical procedures to reduce and reduce the amount of menstrual , Reduce the recurrence rate, it is recommended clinical application.