宫腔镜下选择性子宫内膜切除术治疗月经过多型排卵性功血疗效
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摘要
目的:分析选择性宫腔镜下子宫内膜切除术治疗月经过多型排卵性功血的疗效。方法:74例月经过多型排卵性功血患者按照随机数字表法分为观察组、对照组各37例,分别实施选择性宫腔镜下子宫内膜切除术、传统宫腔镜下子宫内膜切除术治疗,比较两组患者治疗情况、并发症发生情况及临床疗效,探讨选择性宫腔镜下子宫内膜切除术的临床疗效。结果:观察组术中出血量、术后恢复时间、术后阴道排液时间低于对照组,观察组术后出血过多、闭经及月经过少、宫腔粘连发生率低于对照组,差异有统计学意义(P<0.05)。观察组、对照组临床总有效率分别为83.78%、89.19%,组间比较差异无统计学意义(P>0.05)。结论:选择性宫腔镜下子宫内膜切除术治疗月经过多型排卵性功血可起到与传统宫腔镜下手术相同的治疗效果,且安全性更高、患者术后恢复更快。
Objective:This study objective was to analyze the efficacy of selective hysteroscopic endometrial resection in the treatment of ovulatory uterine bleeding complicated with menorrhagia.Methods:74 ovulatory uterine bleeding patients complicated with menorrhagia were divided into observation group and control group according to the random number table with 37 cases each group,who received selective hysteroscopic endometrial resection and traditional hysteroscopic endometrial resection for treatment respectively,the treatment,complications and clinical efficacy were compared between the two groups of patients,and the clinical efficacy selective hysteroscopic endometrial resection was analyzed.Results:The intraoperative blood loss,postoperative recovery time and postoperative vaginal discharge time were lower in the observation group than in the control group.The rates of excessive blood loss after operation,amenorrhea and menstruation,and intrauterine adhesions were lower than those in the control group,and the difference was statistically significant(P<0.05).The total effective rates of the observation group and the control group were 83.78% and 89.19% respectively.There was no significant difference between the two groups(P>0.05).Conclusions:Selective hysteroscopic endometrial resection for the treatment of ovulatory uterine bleeding can achieve the same treatment effect as the traditional hysteroscopic surgery with higher safety and faster recovery after surgery.
Objective:This study objective was to analyze the efficacy of selective hysteroscopic endometrial resection in the treatment of ovulatory uterine bleeding complicated with menorrhagia.Methods:74 ovulatory uterine bleeding patients complicated with menorrhagia were divided into observation group and control group according to the random number table with 37 cases each group,who received selective hysteroscopic endometrial resection and traditional hysteroscopic endometrial resection for treatment respectively,the treatment,complications and clinical efficacy were compared between the two groups of patients,and the clinical efficacy selective hysteroscopic endometrial resection was analyzed.Results:The intraoperative blood loss,postoperative recovery time and postoperative vaginal discharge time were lower in the observation group than in the control group.The rates of excessive blood loss after operation,amenorrhea and menstruation,and intrauterine adhesions were lower than those in the control group,and the difference was statistically significant(P<0.05).The total effective rates of the observation group and the control group were 83.78% and 89.19% respectively.There was no significant difference between the two groups(P>0.05).Conclusions:Selective hysteroscopic endometrial resection for the treatment of ovulatory uterine bleeding can achieve the same treatment effect as the traditional hysteroscopic surgery with higher safety and faster recovery after surgery.
引文
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[10]LEGENDRE G,ZOULOVITS F J,KINN J,et al.Conservative management of placenta accreta:hysteroscopic resection of retained tissues[J].J Minim Invasive Gynecol,2014,21(5):910-913.
[11]TRONCON J K,ZANI A C T,CANDIDO-DOS-REIS F J,et al.Endometrial Polyps-When Should Hysteroscopic Resection Be Performed?[J].Rev Bras Ginecol Obstet,2016,38(7):315-316.
[12]王晓秋.116例宫腔镜子宫内膜切除术治疗功能失调性子宫出血的临床分析[D].长春:吉林大学,2007..
[13]EMANUEL M H.Hysteroscopy and the treatment of uterine fibroids[J].Best Pract Res Clin Obstet Gynaecol,2015,29(7):920-929.
[14]DONNEZ J,DONNEZ O,DOLMANS M M.With the advent of selective progesterone receptor modulators,what is the place of myoma surgery in current practice?[J].Fertil Steril,2014,102(3):640-648.
[15]黄俊英,徐广萍,王素平.选择性宫腔镜手术治疗子宫出血的疗效分析[J].医学信息,2013,26(19):156.
[16]FERRERO S,RACCA A,TAFI E,et al.Ulipristal Acetate Before High Complexity Hysteroscopic Myomectomy:ARetrospective Comparative Study[J].J Minim Invasive Gynecol,2016,23(3):390-395.
[17]MORI M,IWASE A,OSUKA S,et al.Choosing the optimal therapeutic strategy for placental polyps using power Doppler color scor ing:Transar ter ial embolizat ion followed by hysteroscopic resection or expectant management?[J].Taiwan JObstet Gynecol,2016,55(4):534-538.
[18]DOOD R L,GRACIA C R,SAMMEL M D,et al.Endometrial cancer after endometrial ablation vs medical management of abnormal uterine bleeding[J].J Minim Invasive Gynecol,2014,21(5):744-752.
[2]TAKEDA A,KOIKE W,HAYASHI S,et a l.Magnet ic Resonance Imaging and 3-dimensional Computed Tomographic Angiography for Conservative Management of Proximal Interstitial Pregnancy by Hysteroscopic Resection After Transcatheter Arterial Chemoembolization[J].J Minim Invasive Gynecol,2015,22(4):658-662.
[3]李娜,崔潇华,王玉娜,等.选择性宫腔镜下子宫内膜切除术治疗月经过多型排卵性功血的效果[C]//2015临床急重症经验交流第二次高峰论坛.2015.
[4]HIRAKI K,KHAN K N,K ITAJ IMA M,et al.Uter ine preservation surgery for placental polyp[J].J Obstet Gynaecol Res,2014,40(1):89-95.
[5]PRITTS E A,VANNESS D J,BEREK J S,et al.The prevalence of occult leiomyosarcoma at surgery for presumed uterine fibroids:a meta-analysis[J].Gynecol Surg,2015,12(3):165-177.
[6]BEN-AMI I,MELCER Y,SMORGICK N,et al.A comparison of reproductive outcomes following hysteroscopic management versus dilatation and curet tage of retained products of conception[J].Int J Gynecol Obstet,2014,127(1):86-89.
[7]张红霞.月经过多型排卵性功血子宫内膜形态学改变及宫腔镜下选择性内膜切除术的疗效观察[D].石家庄:河北医科大学,2011.
[8]LOIACONO R M R,TROJANO G,DEL GAUDIO N,et al.Hysteroscopy as a valid tool for endometrial pathology in patients with postmenopausal bleeding or asymptomatic patients with a thickened endometrium:hysteroscopic and histological results[J].Gynecol Obstet Invest,2015,79(3):210-216.
[9]刘建.热球和经宫颈子宫内膜切除术对功血患者治疗的效果和安全性比较[D].广州:南方医科大学,2009.
[10]LEGENDRE G,ZOULOVITS F J,KINN J,et al.Conservative management of placenta accreta:hysteroscopic resection of retained tissues[J].J Minim Invasive Gynecol,2014,21(5):910-913.
[11]TRONCON J K,ZANI A C T,CANDIDO-DOS-REIS F J,et al.Endometrial Polyps-When Should Hysteroscopic Resection Be Performed?[J].Rev Bras Ginecol Obstet,2016,38(7):315-316.
[12]王晓秋.116例宫腔镜子宫内膜切除术治疗功能失调性子宫出血的临床分析[D].长春:吉林大学,2007..
[13]EMANUEL M H.Hysteroscopy and the treatment of uterine fibroids[J].Best Pract Res Clin Obstet Gynaecol,2015,29(7):920-929.
[14]DONNEZ J,DONNEZ O,DOLMANS M M.With the advent of selective progesterone receptor modulators,what is the place of myoma surgery in current practice?[J].Fertil Steril,2014,102(3):640-648.
[15]黄俊英,徐广萍,王素平.选择性宫腔镜手术治疗子宫出血的疗效分析[J].医学信息,2013,26(19):156.
[16]FERRERO S,RACCA A,TAFI E,et al.Ulipristal Acetate Before High Complexity Hysteroscopic Myomectomy:ARetrospective Comparative Study[J].J Minim Invasive Gynecol,2016,23(3):390-395.
[17]MORI M,IWASE A,OSUKA S,et al.Choosing the optimal therapeutic strategy for placental polyps using power Doppler color scor ing:Transar ter ial embolizat ion followed by hysteroscopic resection or expectant management?[J].Taiwan JObstet Gynecol,2016,55(4):534-538.
[18]DOOD R L,GRACIA C R,SAMMEL M D,et al.Endometrial cancer after endometrial ablation vs medical management of abnormal uterine bleeding[J].J Minim Invasive Gynecol,2014,21(5):744-752.