摘要
目的探究宫腔镜下电切术和宫腔镜下刮宫术治疗围绝经期异常子宫出血对患者月经失血图(PBAC)评分及预后的影响。方法回顾性分析2019年8月至2023年8月虞城县人民医院就诊的异常子宫出血患者60例临床资料,按照治疗方法分为电切组(n=39)和刮宫组(n=21),电切组行宫腔镜下电切术治疗,刮宫组行宫腔镜下刮宫术治疗,对比两组术后治疗情况、子宫内膜厚度、PBAC评分、术后并发症及随访1年内复发情况。结果电切组临床总有效率92.31%(36/39),高于刮宫组71.43%(15/21),手术总时长高于刮宫组,术中出血量低于刮宫组,差异有统计学意义(P<0.05);术后3个月时,两组子宫内膜厚度及PBAC评分较术前均降低,且电切组均低于刮宫组,差异有统计学意义(P<0.05);术后两组并发症总发生率比较,差异无统计学意义(P>0.05);随访1年内,电切组复发率10.26%(4/39),低于刮宫组33.33%(7/21),差异有统计学意义(P<0.05)。结论宫腔镜下电切术与宫腔镜下刮宫术均可有效改善子宫内膜厚度及术后月经出血量,但电切术可降低术中出血量,疗效更佳,且复发率更低。
Objective To investigate the effects of hysteroscopic transcervical resection and hysteroscopic curettage on Pictorial Blood Loss Assessment Chart(PBAC)scores and prognosis in patients with perimenopausal abnormal uterine bleeding.Methods The clinical data of 60 patients with abnormal uterine bleeding who were treated at Yucheng County People’s Hospital from August 2019 to August 2023 were retrospectively analyzed.According to the treatment method,the patients were divided into a resection group(n=39)and a curettage group(n=21).The resection group underwent hysteroscopic transcervical resection,while the curettage group underwent hysteroscopic curettage.Postoperative therapeutic efficacy,endometrial thickness,PBAC scores,postoperative complications,and recurrence within 1 year of follow-up were compared between the two groups.Results The overall clinical efficacy rate in the resection group was 92.31%(36/39),which was higher than that in the curettage group(71.43%,15/21)(P<0.05).The operation time was longer in the resection group than in the curettage group,whereas intraoperative blood loss was lower in the resection group than in the curettage group(P<0.05).At 3 months after surgery,endometrial thickness and PBAC scores in both groups were lower than those before surgery,and both indices were lower in the resection group than in the curettage group(P<0.05).There was no statistically significant difference in the overall incidence of postoperative complications between the two groups(P>0.05).During 1 year of follow-up,the recurrence rate in the resection group was 10.26%(4/39),which was lower than that in the curettage group(33.33%,7/21)(P<0.05).Conclusion Both hysteroscopic transcervical resection and hysteroscopic curettage can effectively reduce endometrial thickness and postoperative menstrual blood loss in patients with perimenopausal abnormal uterine bleeding.However,hysteroscopic transcervical resection Results in less intraoperative blood loss,achieves better therapeutic efficacy,and is associated with a lower recurrence rate.
作者
邓慧丽
DENG Huili(Department of Gynecology,Yucheng County People’s Hospital,Shangqiu,Henan 476300,China)
出处
《临床研究》
2025年第12期62-65,共4页
Clinical Research
关键词
异常子宫出血
围绝经期
宫腔镜下电切术
宫腔镜下刮宫术
月经失血图
abnormal uterine bleeding
perimenopause
hysteroscopic transcervical resection
hysteroscopic curettage
Pictorial Blood Loss Assessment Chart
