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目的:探讨子宫内膜息肉电切术前不同内膜预处理方法的疗效。方法:将200例子宫内膜息肉患者分为5组:A组(药物预处理组),又分为A1组(孕三烯酮)60例,A2组[合成促性腺激素释放激素激动剂(GnRH-a)]12例,A3组(醋酸棉酚)58例,B组(机械性预处理组)40例,C组(对照组)30例。5组均行子宫内膜息肉电切术,术后对相关指标进行比较。结果:和C组比较,A1、A2、A3组内膜均较薄,差异有统计学意义(P<0.05);A2组薄化内膜的效果优于其他处理组,差异有统计学意义(P<0.05)。和C组比较,A1、A2、A3组内膜单位面积的腺体数目较少,差异有统计学意义(P<0.05);A2组内膜单位面积的腺体数目少于A1组及A3组,差异有统计学意义(P均<0.05)。和C组比较,A1、A2、A3组内膜间质较致密,差异有统计学意义(P均<0.05)。和C组比较,A1、A2、A3、B组手术需要时间较短,差异有高度统计学意义(P<0.01)。A1、A2、A3组的无月经率明显高于C组及B组。结论:宫腔镜术前进行内膜预处理可提高手术效果及取得较好的月经改善。宫腔镜术前内膜预处理方法的选择应个体化。
Objective: To investigate the efficacy of different methods of endometrial pretreatment before resection of endometrial polyps. Methods: 200 cases of endometrial polyps were divided into 5 groups: group A (drug pretreatment group), group A1 (gestrinone) 60, group A2 [synthetic gonadotropin-releasing hormone agonist 12 cases of GnRH-a), 58 cases of A3 (gossypol acetate), 40 cases of group B (mechanical pretreatment group) and 30 cases of group C (control group). All 5 groups underwent resection of endometrial polyps, and the related indexes were compared after operation. Results: Compared with group C, the intima of group A1, A2 and A3 were thinner and the difference was statistically significant (P <0.05). The effect of group A2 in thinning intimal thickening was better than that in other groups P <0.05). Compared with group C, the numbers of glands per unit area in A1, A2 and A3 groups were less, the difference was statistically significant (P <0.05); the number of glands per unit area in A2 group was less than A1 group and A3 group , The difference was statistically significant (P <0.05). Compared with group C, the intima-media between groups A1, A2 and A3 were denser (P <0.05). Compared with group C, the operation time of group A1, A2, A3 and B was shorter and the difference was statistically significant (P <0.01). A1, A2, A3 group, no menstrual rate was significantly higher than the C group and B group. Conclusion: Hysteroscopic preoperative endometrial preconditioning can improve the surgical results and achieve better menstrual improvement. Hysteroscopic preoperative endometrial pretreatment selection should be individualized.