子宫内膜息肉不孕症患者激素表达水平及宫腔镜下不同治疗方式的疗效对比

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.

Comparison of hormone expression level and different hysteroscopic surgery in patients with endometrial polyps infertility

Objective To investigate the expression of endometrial polyps infertility patients with hormone levels and com-pared the treatment effect analysis of hysteroscopic electroresection and curettage. Methods 80 cases of endometrial polyps infertility from June 2015 to June 2016 in our hospital were selected as case group, according to the operation mode, the case group were divided into electroresection group (42 cases) and curettage group (38 cases).40 infertility casesdue tospouse factors were selected as control group. Estrogen receptor (ER) and progesterone receptor (PR) were detected in each group. Observed electroresection group and curettage group's menstrual changes before and after surgery3 months, 6 months and 12 months. The recurrence rate and pregnancy rate were compared between the two groups after 1 years. Results There were no signifi-cant differences in the expression of ER in glandular epithelial cells and stromal cells between each group; Curettage group and electroresection group's expression of PR in the glandular epithelial cells and stromal cells was significantly lower than that of the control group, the difference was statistically significant. After 3 months, 6 months and 12 months, electroresection group's amount of menstruation was less than before and that of the control group, and the difference was statistically significant; After 3 months and 6 months, the amount of menstruation was less than before of the control group, but after 12 months, the amount of menstruation returned to the preoperative level. After 1 years, curettage group's recurrence rate was 26.3%, significantly higher than the electroresection group's recurrence rate 2.4%, the difference was statistically significant; After 1 years, the curettage group's pregnancy rate was 60.5%, electroresection group's pregnancy rate was 61.9%, there was no significant difference be-tween the two groups. Conclusion Endometrial polyps were closely related to the imbalance of the expression of ER and PR in the endometrium. Hysteroscopic electroresectionin the treatment of endometrial polyps infertility was better, the operation can improve the long-term and reduce the amount of menstruation, reduce the recurrence rate, it was worth proposed clinical appli-cation.