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目的:比较宫腔镜下微型剪刀剪除息肉加电凝术与宫腔镜下子宫内膜息肉电切除术治疗子宫内膜息肉不孕症患者的疗效。方法:78例异常子宫出血的不孕症患者经B超联合宫腔镜检查诊断为子宫内膜息肉,用随机表法分为两组:A组38例行宫腔镜下微型剪刀剪除息肉加电凝术,B组40例行宫腔镜下子宫内膜息肉电切除术。比较两组患者手术情况、术后1年月经量的情况、随访1年妊娠和复发情况。结果:手术时间、出血量及并发症,两组比较无统计学差异(P>0.05)。A组治疗后半年内月经量明显减少(P<0.05),1年时月经量无明显减少(P>0.05);B组治疗后半年内、1年时月经量较治疗前明显减少(P<0.05)。半年内两组妊娠率比较无统计学差异(P>0.05),1年时两组妊娠率差异有统计学意义(P<0.05)。半年内两组复发率比较无统计学差异(P>0.05),但1年时两组复发率比较有统计学差异(P<0.05)。结论:宫腔镜下微型剪刀剪除息肉加电凝术疗效主要见于治疗后半年内,而宫腔镜下子宫内膜息肉电切除术在术后1年仍保持良好疗效。
Objective: To compare the curative effect of hysteroscopic mini scissors to remove polyps and electrocoagulation and hysteroscopic endometrial polyp resection for infertility patients with endometrial polyps. Methods: Eighty-eight infertile patients with abnormal uterine bleeding were diagnosed as endometrial polyps by B-ultrasound combined with random table method: 38 cases in group A underwent hysteroscopic mini-scissors to remove the polyps, Coagulation, group B 40 cases of hysteroscopic endometrial polyp resection. The operation conditions of the two groups were compared, the menstrual volume at one year after operation, the pregnancy and recurrence after one year follow-up. Results: There was no significant difference between the two groups in the operation time, bleeding volume and complications (P> 0.05). The amount of menstruation in group A was significantly reduced (P <0.05) within one half of treatment, and the amount of menstruation was not significantly reduced at one year (P> 0.05). The amount of menstrual flow in group B was significantly decreased at one year after operation (P < 0.05). There was no significant difference in pregnancy rates between the two groups within six months (P> 0.05). There was significant difference in pregnancy rates between the two groups at one year (P <0.05). There was no significant difference in relapse rate between the two groups within six months (P> 0.05), but there was a significant difference in relapse rate between the two groups at one year (P <0.05). Conclusion: Hysteroscopic miniature scissors to remove polyp electrocoagulation is mainly seen within six months after treatment, while hysteroscopic endometrial polyp resection remains good after 1 year.