宫腔镜下不同手术方式对子宫内膜息肉患者手术时间和子宫内膜厚度的影响

Impacts of different surgical methods under hysteroscopy on the surgical time and endometrial thickness in patients with endometrial polyp

摘要:

目的 探究宫腔镜下不同手术方式对子宫内膜息肉（EP）患者手术时间和子宫内膜厚度的影响。方法 选取2021年4月－2023年4月于该院就诊的EP患者180例，按手术方法不同，将患者分为A组、B组和C组，各60例。A组接受宫腔镜电切术，B组接受宫腔镜冷刀手术，C组采用宫腔镜刨削系统进行手术。比较3组患者治疗前后月经失血图（PBAC）评分、子宫内膜厚度、术中出血量、住院时间、手术时间、住院费用、临床疗效、并发症发生率、妊娠率和复发率。结果 C组术中出血量明显少于A组和B组，住院时间和手术时间明显短于A组和B组，住院费用明显高于A组和B组，差异均有统计学意义（P < 0.05）。C组PBAC评分明显低于A组和B组，子宫内膜厚度明显小于A组和B组，差异均有统计学意义（P < 0.05）。A组总有效率明显低于B组和C组，差异均有统计学意义（P < 0.05），但B组和C组比较，差异无统计学意义（P > 0.05）。C组和B组并发症发生率明显低于A组，差异有统计学意义（P < 0.05），但B组和C组比较，差异无统计学意义（P > 0.05）。3组患者12个月内的复发率比较，差异无统计学意义（P > 0.05）。C组妊娠率明显高于A组和B组，且B组明显高于A组，差异均有统计学意义（P < 0.05）。结论 宫腔镜下刨削术较其他宫腔镜手术方法，更能有效清除病灶，缩短手术时间，减少术中出血量，减少子宫内膜厚度，有效促进患者月经恢复，安全性高。

Abstract:

Objective To explore the impacts of different surgical methods under hysteroscopy on the surgical time and endometrial thickness of patients with endometrial polyp (EP).Methods 180 patients with EP from April 2021 to April 2023 were regarded as the subjects. They were separated into group A, group B, and group C according to surgical methods, with 60 cases in each. Group A underwent hysteroscopic resection, group B underwent hysteroscopic cold knife surgery, and group C underwent hysteroscopic curettage surgery. The pictorial blood loss assessment chart (PBAC) score before and after treatment, endometrial lesion, intraoperative bleeding volume, hospitalization time, surgical time, hospitalization cost, clinical efficacy, complications, pregnancy rate and recurrence rate were compared.Results The intraoperative bleeding volume in group C was obviously less than that in group A and group B, hospitalization time, and surgical time were obviously shorter than those in group A and group B, and the hospitalization cost was obviously higher than that in group A and group B, the differences were statistically significant (P < 0.05). The PBAC score in groups C was obviously less than that in group A and group B, the endometrial thickness was obviously smaller than that in group A and group B, the differences were statistically significant (P < 0.05). The clinical efficacy of group A was obviously lower than that of group B and group C, the differences were statistically significant (P < 0.05), and there was no statistically obvious difference between group B and group C (P > 0.05). The complication rate in group C and group B were obviously less than that in group A (P < 0.05), and there was no statistically obvious difference between group B and group C (P > 0.05). The recurrence rate within 12 months in three groups was not statistically significant (P > 0.05). The pregnancy rate in group C was obviously higher than that in group B and group A, and group B was higher than group A, the differences were statistically significant (P < 0.05).Conclusion Hysteroscopic curettage is more effective in clearing lesions, shortening surgical time, reducing intraoperative bleeding, lowering endometrial thickness, and promoting menstrual recovery in patients compared to other hysteroscopic surgical methods, with high safety.