子宫内膜息肉不孕患者宫腔镜下不同治疗方式的疗效观察

目的:比较宫腔镜下微型剪刀剪除息肉加电凝术与宫腔镜下子宫内膜息肉电切除术治疗子宫内膜息肉不孕症患者的疗效。方法:78例异常子宫出血的不孕症患者经B超联合宫腔镜检查诊断为子宫内膜息肉,用随机表法分为两组:A组38例行宫腔镜下微型剪刀剪除息肉加电凝术,B组40例行宫腔镜下子宫内膜息肉电切除术。比较两组患者手术情况、术后1年月经量的情况、随访1年妊娠和复发情况。结果:手术时间、出血量及并发症,两组比较无统计学差异(P>0.05)。A组治疗后半年内月经量明显减少(P<0.05),1年时月经量无明显减少(P>0.05);B组治疗后半年内、1年时月经量较治疗前明显减少(P<0.05)。半年内两组妊娠率比较无统计学差异(P>0.05),1年时两组妊娠率差异有统计学意义(P<0.05)。半年内两组复发率比较无统计学差异(P>0.05),但1年时两组复发率比较有统计学差异(P<0.05)。结论:宫腔镜下微型剪刀剪除息肉加电凝术疗效主要见于治疗后半年内,而宫腔镜下子宫内膜息肉电切除术在术后1年仍保持良好疗效。

Observation on curative effects of different therapeutic modes under hysteroscope for infertile patients with endometrial polyps

Objective:To compare the curative effects of cutting polys with a mini-scissor plus electrocoagulation under hysteroscope and electroresection of endometrial polys under hysteroscope in treatment of infertile women with endometrial polys. Methods:Seven-eight infertile women with abnormal uterine bleeding were diagnosed as endometrial polys by B ultrasonography combined with hysteroscopy,then they were divided into two groups according to random number table method: 38 patients in group A were treated with cutting polys with a mini-scissor plus electrocoagulation under hysteroscope,while 40 patients in group B were treated with electroresection of endometrial polys under hysteroscope.The operation situations,the menstrual volumes at one year after operation,the pregnancy and recurrence situations during follow-up for one year in the two groups were compared. Results:There was statistically significant difference in the operation time,the amount of bleeding,and the complications between the two groups(P>0.05).The menstrual volume in group A decreased significantly at half a year after treatment(P<0.05),but at one year after treatment,the menstrual volume didn’t decrease significantly(P>0.05);in group B,the menstrual volumes at half a year and one year after treatment were significantly lower than that before treatment(P<0.05).There was no statistically significant difference in pregnancy rate at half a year after treatment between the two groups(P>0.05),but there was statistically significant difference in pregnancy rate at one year after treatment between the two groups(P<0.05).There was no statistically significant difference in recurrence rate at half a year after treatment between the two groups(P>0.05),but there was statistically significant difference in recurrence rate at one year after treatment between the two groups(P<0.05). Conclusion:The curative effect of cutting polys with a mini-scissor plus electrocoagulation under hysteroscope is significant only at half a year after treatment,while electroresection of endometrial polys under hysteroscope still maintains good curative effect at one year after treatment.