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目的探讨3种不同宫腔镜电切术治疗子宫内膜息肉(endometrial polyps,EMP)的临床疗效和复发率。方法回顾性分析2015~2016年143例在广安市人民医院进行宫腔镜电切术治疗的EMP患者的临床资料,根据年龄和生育要求,分为宫腔镜子宫内膜息肉电切术(transcervical resection of endometrial polyps,TCRP)组(63例),TCRP+部分宫腔镜子宫内膜电切术(transcervical resection of endometrium,TCRE)组(49例)和TCRP+宫腔镜下滚球电极电凝去内膜术(roller-boll endometrial ablation,REA)组(31例)。随访1~12个月,详细记录患者月经情况,复发情况以及妊娠情况。结果与其他两组比较,TCRP组患者手术时间最短,术中失血量最少(P<0.05);所有患者顺利完成手术,术中未发生严重并发症。术后,TCRP组2例患者出现轻度头晕,其余两组各有1例患者发生一过性体温升高;99例月经紊乱患者术后月经情况得到显著改善;术后复查结果显示,3组患者术后症状改善率均较高,差异无统计学意义(P>0.05)。TCRP组有3例(4.76%)患者复发;TCRP+部分TCRE组有1例患者复发,而TCRP+REA组无患者复发。术前,TCRP组有13例有生育要求的患者不孕,随访1年,有7例患者自然受孕,妊娠率为53.85%;另外两组患者无妊娠。结论宫腔镜电切术可有效改善EMP患者的临床症状,复发率低,应根据患者病情和治疗要求,选择个体化电切术方案。
Objective To investigate the clinical efficacy and recurrence rate of endometrial polyps (EMP) by three different types of hysteroscopic electrotomy. Methods The clinical data of 143 EMP patients undergoing hysteroscopic resection in Guang’an People’s Hospital from 2015 to 2016 were retrospectively analyzed. According to the age and fertility requirements, they were divided into hysteroscopic endoscopic polypectomy (transcervical) resection of endometrial polyps (TCRP) group (n = 63), TCRP + partial hysteroscopic endocervical resection of endometrium (TCRE) group (n = 49) The group of roller-boll endometrial ablation (REA) (31 cases). Follow-up 1 to 12 months, a detailed record of patients with menstrual conditions, recurrence and pregnancy status. Results Compared with the other two groups, the operation time of the patients in the TCRP group was the shortest, and the blood loss was the least during the operation (P <0.05). All the patients completed the operation smoothly without any serious complications. After operation, mild dizziness occurred in 2 patients in TCRP group and transient temperature increase occurred in 1 patient in the other two groups. The menstrual condition in 99 patients with menstrual disorders was significantly improved after operation. The results of postoperative examination showed that in group 3 The postoperative symptom improvement rate was higher in patients with no significant difference (P> 0.05). Three patients (4.76%) in TCRP group relapsed; one patient recurred in TCRP + partial TCRE group and no recurrence in TCRP + REA group. Preoperative, TCRP group of 13 cases of fertility requirements of patients with infertility, followed up for 1 year, 7 patients with natural conception, the pregnancy rate was 53.85%; the other two groups of patients without pregnancy. Conclusion Hysteroscopic resection can effectively improve the clinical symptoms of EMP patients, the recurrence rate is low, according to the patient’s condition and treatment requirements, select the individualized electrosurgical regimen.