宫腔镜刨削系统联合屈螺酮炔雌醇片治疗子宫内膜息肉的效果观察

Effect of hysteroscopic shaver system combined with drospirenone and ethinyl estradiol tablets in the treatment of endometrial polyps

摘要:

目的 探讨宫腔镜刨削系统联合屈螺酮炔雌醇片治疗子宫内膜息肉的效果。方法 前瞻性选取2021年1月—2023年1月南京医科大学常州医学中心常州市妇幼保健院收治的116例子宫内膜息肉患者，采用随机数字表法分为对照组和研究组，各58例。对照组给予传统宫腔镜下电切术联合屈螺酮炔雌醇片治疗，研究组给予宫腔镜刨削系统联合屈螺酮炔雌醇片治疗，术后随访6个月。比较两组患者手术情况、月经恢复情况、子宫内膜动脉血流动力学、性激素、血清指标、并发症、近期预后情况。结果 研究组手术时间、膨宫液用量、术中出血量、术后月经恢复时间均低于对照组（P <0.05）。研究组治疗前后的子宫内膜厚度、子宫动脉收缩期峰值流速、搏动指数、阻力指数差值均高于对照组（P <0.05）。两组治疗前后的雌二醇、孕酮、促卵泡生成素差值比较，差异无统计学意义（P >0.05）。研究组治疗前后的转化生长因子-β₁、纤溶酶原激活剂抑制因子-1差值均高于对照组（P <0.05）。研究组总并发症发生率低于对照组（P <0.05）。研究组复发率低于对照组（P <0.05）；两组临床妊娠成功率比较，差异无统计学意义（P >0.05）。结论 宫腔镜刨削系统联合屈螺酮炔雌醇片治疗子宫内膜息肉可减少手术时间、膨宫液用量、术中出血量，明显提高子宫动脉血流动力学，术后复发风险低，安全可靠。

Abstract:

Objective To investigate the effect of hysteroscopic shaver system combined with drospirenone and ethinyl estradiol tablets in the treatment of endometrial polyps.Methods The 116 patients with endometrial polyps admitted to our hospital from January 2021 to January 2023 were prospectively selected and divided into the control group and the study group by the random number table method, with 58 cases in each group. The control group was treated with routine hysteroscopic electrosurgery combined with drospirenone and ethinyl estradiol tablets, and the study group was treated with hysteroscopic shaver system combined with drospirenone and ethinyl estradiol tablets. The postoperative follow-up period was 6 months. The surgery-related indicators, menstrual recovery, uterine artery hemodynamics, sex hormones, serum indicators, complications and short-term prognosis were compared between the two groups.Results The operative duration and postoperative menstrual recovery time were shorter, and amount of fluid for uterine distention used and intraoperative blood loss were lower in the study group than those in the control group (P < 0.05). The differences of endometrial thickness, uterine artery peak systolic velocity, pulsatility index and resistive index before and after treatment in the study group were higher than those in the control group (P < 0.05). There was no significant difference in the differences of levels of estradiol, progesterone and follicle-stimulating hormone before and after treatment between the two groups (P > 0.05). The differences of levels of transforming growth factor-β1 and plasminogen activator inhibitor-1 before and after treatment in the study group were greater than those in the control group (P < 0.05). The overall incidence of complications in the study group was lower than that in the control group (P < 0.05). The recurrence rate of the study group was lower than that of the control group (P < 0.05). There was no significant difference in the clinical pregnancy success rate between the two groups (P > 0.05).Conclusions In the treatment of endometrial polyps, hysteroscopic shaver system combined with drospirenone and ethinyl estradiol tablets can reduce the operative duration, amount of fluid for uterine distention used and intraoperative blood loss, and improve uterine artery hemodynamics more significantly. Besides, it has a low risk of postoperative recurrence, and is safe and reliable.