宫腔镜刨削系统与电切系统治疗育龄女性宫腔良性病变的疗效及对妊娠结局的影响

    The effect of hysteroscopic resection system and electrocautery system in the treatment of benign uterine lesions in reproductive-aged women and their impact on pregnancy outcomes

    • 摘要:
      目的: 探讨宫腔镜刨削系统与宫腔镜电切系统治疗育龄女性宫腔良性病变的临床疗效及对术后妊娠结局的影响。
      方法: 选取156例育龄女性宫腔良性病变病人作为研究对象,根据手术方法分为刨削组(78例,采用宫腔镜刨削系统治疗)和电切组(78例,采用宫腔镜电切系统治疗),比较2组围手术期指标(手术时间、住院时间、术中出血量)、凝血功能凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、术后恢复情况月经恢复时间、血绒毛膜促性腺激素(HCG)恢复正常时间、子宫内膜厚度、术后并发症以及术后妊娠率。
      结果: 刨削组手术时间、住院时间均短于电切组,术中出血量低于电切组(P < 0.01);刨削组PT、APTT、FIB水平低于电切组(P < 0.01);刨削组月经恢复时间、血HCG恢复正常时间短于电切组,子宫内膜厚度高于电切组(P < 0.01);刨削组术后并发症的发生率为6.41%,低于电切组的17.95%(P < 0.05);刨削组术后1年妊娠率为35.90%,高于电切组的17.95%(P < 0.05)。
      结论: 相较于宫腔镜电切系统,宫腔镜刨削系统治疗育龄女性宫腔良性病变可显著缩短手术时间和住院时间,改善凝血功能,减少术后并发症,加快术后恢复,进而提高术后妊娠率。

       

      Abstract:
      Objective To explore the clinical efficacy of hysteroscopic shaving system and hysteroscopic electrotomy system in the treatment of benign uterine lesions in women of childbearing age and their influence on postoperative pregnancy outcomes.
      Methods A total of 156 female patients of childbearing age with benign uterine cavity lesions were selected as the research subjects, and divided into the shaving group (78 cases treated with hysteroscopic shaving system) and electrotomy group (78 cases treated with hysteroscopic electrotomy system) according to the surgical methods. The perioperative indicators (operation time, hospital stay, intraoperative blood loss), coagulation functionprothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), postoperative recovery statusmenstrual recovery time, time for blood human chorionic gonadotropin (HCG) to return to normal, endometrial thickness and postoperative complications pregnancy rate were compared between two groups.
      Results The operation time and hospital stay in the shaving group were both shorter than those in electrotomy group, and the intraoperative blood loss was lower than that in the electrotomy group (P < 0.01). The levels of PT, APTT and FIB in the shaving group were lower than those in the electrotomy group (P < 0.01). The recovery time of menstruation and time for blood HCG to return to normal in the shaving group were shorter than those in the electrotomy group, and the endometrial thickness was higher than that in the electrotomy group (P < 0.01). The incidence of postoperative complications in the shaving group was 6.41%, which was lower than 17.95% in the electrotomy group (P < 0.05). The pregnancy rate one year after the operation in the shaving group was 35.90%, which was higher than 17.95% in the electrotomy group (P < 0.05).
      Conclusions Compared with the hysteroscopic electrotomy system for women of child-bearing age uterine benign lesions, the hysteroscopic shaving system can significantly shorten the operation time and hospitalization time, improve the function of blood coagulation, reduce the postoperative complications, accelerate the postoperative recovery, and improve the postoperative pregnancy rate.

       

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