摘要
目的探究及观察宫腔镜下子宫内膜息肉切除术对患者子宫内膜容受及局部炎症反应的影响。方法将2018年8月—2019年8月北京中医药大学房山医院的80例子宫内膜息肉切除术患者依据随机数字表法分为对照组40例和观察组40例。对照组进行宫腔镜下子宫内膜息肉钳夹术治疗,观察组则进行宫腔镜下子宫内膜息肉切除术治疗。比较两组的手术时间、术中出血量、并发症发生率、复发率、手术前后的月经量、子宫内膜厚度、子宫内膜容受{子宫内膜下螺旋动脉血流指标[搏动指数(pulsatility index,PI)及阻力指数(resistance index,RI)]及子宫内膜血流分型}、局部炎症反应指标[宫腔灌洗液白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin-6,IL-6)及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]。结果两组的手术时间、术中出血量及并发症发生率比较,差异无统计学意义(P>0.05),观察组术后6个月及12个月的复发率显著低于对照组,差异有统计学意义(P<0.05),术前两组的月经量、子宫内膜厚度、子宫内膜下螺旋动脉血流指标、子宫内膜血流分型及局部炎症反应指标比较,差异无统计学意义(P>0.05),术后6个月及12个月观察组的月经量显著少于对照组,子宫内膜厚度显著低于对照组,子宫内膜下螺旋动脉血流指标、子宫内膜血流分型显著优于对照组,术后1个月及3个月观察组的局部炎症反应指标显著低于对照组,差异有统计学意义(P<0.05)。结论宫腔镜下子宫内膜息肉切除术有助于改善患者的子宫内膜容受及控制局部炎症反应,在子宫内膜息肉患者中的应用价值相对更高。
Objective To investigate and observe the influence of excision of endometrial polyps by hysteroscopy for endometrial receptivity and local inflammatory response of patients.Methods A total of 80 patients with endometrial polyps in Fangshan Hospital, Beijing University of Chinese Medicine from August 2018 to August 2019 were divided into the control group 40 cases and the observation group 40 cases by the method of random number table. The control group was treated with hysteroscopic endometrial polyp clamping, while the observation group was treated with hysteroscopic endometrial polypectomy. The operation time, intraoperative blood loss, complication rate, recurrence rate, menstrual flow before and after operation, endometrial thickness, and endometrial receptivity {subendometrial spiral artery blood flow indexes [pulsatility index (PI) and resistance index (RI)], and endometrial blood flow classification}, local inflammatory response indicators [uterine lavage fluid interleukin- 1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)]. were compared between the two groups. Results There were no significant differences in the operation time, intraoperative blood loss and complication rate between the two groups (P > 0.05). The recurrence rate of the observation group at 6 months and 12 months after operation was significantly lower than that of the control group, the differences were statistically significant (P < 0.05), there were no significant differences in menstrual flow, endometrial thickness, subendometrial spiral artery blood flow index, endometrial blood flow classification and local inflammatory response index between the two groups before surgery (P > 0.05), the menstrual flow of the observation group was significantly lower than that of the control group at 6 months and 12 months after the operation, the endometrial thickness was significantly lower than that of the control group,the subendometrial spiral artery blood flow indexes and endometrial blood flow classification were significantly better than those of the control group. The local inflammatory response indexes of the observation group were significantly lower than those of the control group at 1 month and 3 months after operation, and the differences were statistically significant. (P < 0.05). Conclusion The excision of endometrial polyps by hysteroscopy can effectively improve the endometrial receptivity and control the local inflammatory response of patients, so its clinical application value in the patients with endometrial polyps is relatively higher.
作者
郭健
李灵花
肖虹
GUO Jian;LI Linghua;XIAO Hong(Department of Obstetrics and Gynecology,Fangshan Hospital,Beijing University of Chinese Medicine,Beijing 102400,China)
出处
《中国卫生标准管理》
2022年第15期82-86,共5页
China Health Standard Management
