中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
CHINESE JOURNAL OF MATERNAL AND CHILD HEALTH RESEARCH
2013年
5期
718-720
,共3页
宫腔镜%子宫内膜息肉%手术治疗%个体化
宮腔鏡%子宮內膜息肉%手術治療%箇體化
궁강경%자궁내막식육%수술치료%개체화
hysteroscopy%endometrial polyps%surgical treatment%individualization
目的：探讨宫腔镜治疗子宫内膜息肉的方法和效果。方法收集2008年10月至2012年3月在江苏省扬州市妇幼保健院宫腔镜下诊断为子宫内膜息肉的病例共123例，根据病史、宫腔镜检查结果及患者是否有生育要求分别行宫腔镜定位下息肉摘除术（组）、电切术（组）和吸刮后电切术（组），观察随访3组患者的术中术后情况。结果123例患者均顺利完成手术，无术后感染、大出血及子宫穿孔发生。3组病例术中出血量比较无统计学差异；平均手术时间吸刮后电切术组最长，有统计学意义（F＝109．89，P＜0．05）；术后随访一年，异常子宫出血患者症状改善率吸刮后电切术组最高（χ2＝65．45，P＜0．05），合并不育患者的妊娠率息肉摘除术组最高（χ2＝65．45，P＜0．05），3种手术方式中摘除术组复发率最高（χ2＝3．48，P＜0．05），均有统计学意义。结论宫腔镜下治疗子宫内膜息肉的3种手术方式均切实可行，而对不同症状、不同年龄、不同生育要求的患者选择不同手术方式进行治疗，是手术成功的关键。
目的：探討宮腔鏡治療子宮內膜息肉的方法和效果。方法收集2008年10月至2012年3月在江囌省颺州市婦幼保健院宮腔鏡下診斷為子宮內膜息肉的病例共123例，根據病史、宮腔鏡檢查結果及患者是否有生育要求分彆行宮腔鏡定位下息肉摘除術（組）、電切術（組）和吸颳後電切術（組），觀察隨訪3組患者的術中術後情況。結果123例患者均順利完成手術，無術後感染、大齣血及子宮穿孔髮生。3組病例術中齣血量比較無統計學差異；平均手術時間吸颳後電切術組最長，有統計學意義（F＝109．89，P＜0．05）；術後隨訪一年，異常子宮齣血患者癥狀改善率吸颳後電切術組最高（χ2＝65．45，P＜0．05），閤併不育患者的妊娠率息肉摘除術組最高（χ2＝65．45，P＜0．05），3種手術方式中摘除術組複髮率最高（χ2＝3．48，P＜0．05），均有統計學意義。結論宮腔鏡下治療子宮內膜息肉的3種手術方式均切實可行，而對不同癥狀、不同年齡、不同生育要求的患者選擇不同手術方式進行治療，是手術成功的關鍵。
목적：탐토궁강경치료자궁내막식육적방법화효과。방법수집2008년10월지2012년3월재강소성양주시부유보건원궁강경하진단위자궁내막식육적병례공123례，근거병사、궁강경검사결과급환자시부유생육요구분별행궁강경정위하식육적제술（조）、전절술（조）화흡괄후전절술（조），관찰수방3조환자적술중술후정황。결과123례환자균순리완성수술，무술후감염、대출혈급자궁천공발생。3조병례술중출혈량비교무통계학차이；평균수술시간흡괄후전절술조최장，유통계학의의（F＝109．89，P＜0．05）；술후수방일년，이상자궁출혈환자증상개선솔흡괄후전절술조최고（χ2＝65．45，P＜0．05），합병불육환자적임신솔식육적제술조최고（χ2＝65．45，P＜0．05），3충수술방식중적제술조복발솔최고（χ2＝3．48，P＜0．05），균유통계학의의。결론궁강경하치료자궁내막식육적3충수술방식균절실가행，이대불동증상、불동년령、불동생육요구적환자선택불동수술방식진행치료，시수술성공적관건。
Objective To explore the methods and efficacy of hysteroscopic surgical treatment for endometrial polyps .Methods Totally 123 patients were diagnosed with endometrial polyps under hysteroscopy in Yangzhou Municipal Maternal and Child Health Hospital from October 2008 to March 2012.Hysteroscopic localization ( hysteroscopic localization group ), electrocision ( electrocision group ) or electrocision after suction and curettage ( electrocision after suction and curettage group ) was performed according to patients ’ medical history, hysteroscopic examination and fertility requirements .The intraoperative and postoperative conditions of the patients were followed up.Results All of 123 patients underwent surgery successfully .No complication , hemorrhage or uterine perforation occurred after operation.Intraoperative blood loss of three groups was not significantly different .However, the mean operative time for electrocision after suction and curettage group was longest in three groups (F=109.89,P<0.05), and the improvement rate of abnormal uterine hemorrhage in patients undergoing electrocision after suction and curettage was highest (χ2 =65.45,P<0.05) after one year follow-up.The highest pregnant rate was found in infertile patients undergoing hysteroscopic localization (χ2 =65.45, P <0.05 ).The recurrence rate in hysteroscopic localization group was highest among three groups (χ2 =3.48,P<0.05).There were statistically significant differences . Conclusion All of the operational methods are effective .It is important to take different approach according to different symptoms , age or fertility requirments in the treatment of endometrial polyps .
