|［摘要］ 目的 比较两种宫腔镜手术方式切除多发性子宫内膜息肉的疗效。方法 回顾性分析2020年12月至2021年12月该院收治的多发性子宫内膜息肉患者246例的临床资料，其中145例行宫腔镜下电切术（电切组），101例行宫腔镜下冷刀切除术（冷刀组），比较两组手术时间、术中出血量，术后阴道流血时间、住院时间。术后均随访1年，比较两组术后并发症、息肉复发以及妊娠情况。结果 冷刀组手术时间、术后阴道流血时间均长于电切组，但差异无统计学意义（P>0.05）。两组术后复发率比较差异无统计学意义（15.84% vs 13.79%，P>0.05）。冷刀组术后妊娠率高于电切组，差异有统计学意义（25.74% vs 11.03%，P<0.05）。两组术后均未见盆腔感染、闭经等主要并发症发生。结论 宫腔镜下冷刀切除多发性子宫内膜息肉与传统的宫腔镜电切手术一样安全有效，虽然可能增加手术时间及术后阴道流血时间，但能更好地保护患者的生育能力。
|关键词: 多发性子宫内膜息肉 宫腔镜手术 冷刀 妊娠 复发
|Comparison of the clinical effects of two kinds of hysteroscopic surgery in resection of multiple endometrial polyps
ZHANG Li, CHEN Yan, HAN Jiao-jiao, et al.
Department of Obstetrics and Gynecology, Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital(Chengdu First People′s Hospital), Sichuan 610041, China
|［Abstract］ Objective To compare the clinical effects of two kinds of hysteroscopic surgery in resection of multiple endometrial polyps. Methods The clinical data of 246 patients with multiple endometrial polyps admitted to Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital(Chengdu First People′s Hospital) from December 2020 to December 2021 were retrospectively analyzed, including 145 cases of hysteroscopic endometrial polypectomy(the electrosurgical group) and 101 cases of hysteroscopic cold knife resection(the cold knife group). The operation time, intraoperative blood loss, postoperative vaginal bleeding time and hospital stay were compared between the two groups. The postoperative complications, polyp recurrence and pregnancy outcomes were compared between the two groups after the patients were followed up for 1 year. Results The operation time and the postoperative vaginal bleeding time in the cold knife group was longer than that in the electrosurgical group, but there was no significant difference between the two groups(P>0.05). There was no statistically significant difference in the postoperative recurrence rate between the two groups(15.84% vs 13.79%, P>0.05). The pregnancy rate after operation in the cold knife group was higher than that in the electrosurgical group, and the difference was significantly different between the two groups(25.74% vs 11.03%, P<0.05). There were no major complications such as pelvic infection and postoperative amenorrhea in the two groups after operation. Conclusion Hysteroscopic cold knife resection is as safe and effective as traditional hysteroscopic electrotomy in the resection of multiple endometrial polyps. Although hysteroscopic cold knife resection may lengthen the operation time and the postoperative vaginal bleeding time, it can better protect the patients′ fertility.
|Key words: Multiple endometrial polyps Hysteroscopic surgery Cold knife Pregnancy Recrudescence