临床误诊误治2025，Vol.38Issue(17)：55-59,5.DOI:10.3969/j.issn.1002-3429.2025.17.012
黄体期和卵泡期行宫腔镜子宫内膜息肉切除术的有效性与安全性对比分析
Comparative analysis of the effect and safety of hysteroscopic endometrial polyp resection during the luteal phase and follicular phase
摘要
Abstract
Objective To explore the effects of hysteroscopic endometrial polyp resection during the luteal phase and follicular phase on therapeutic effect,surgical trauma,sex hormones,postoperative complications and recurrence rate.Methods A total of 140 patients with endometrial polyps diagnosed from January 2021 to January 2024 were selected and divided into the luteal phase group(n=70)and the follicular phase group(n=70)using the random number table method.The luteal phase group underwent hysteroscopic surgery during the luteal phase,while the follicular phase group underwent hysteroscopic surgery during the follicular phase.The main therapeutic effect indicators[pictorial blood loss assessment chart(PBAC)score,endometrial thickness,menstrual duration],surgery-related indicators(duration of operation,intraoperative blood loss,postoperative anal exhaust time,length of hospital stay),and surgical trauma indicators before and after surgery[cortisol(Cor),adrenocorticotropic hormone(ACTH),norepinephrine(NE)],sex hormones before and after surgery[luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradiol(E2)],as well as postoperative complications and recurrence rates were compared between the two groups.Results Compared with those before the operation,PBAC score,endometrial thickness and menstrual duration at 3 months after surgery in both groups were significantly decreased or shortened(P<0.01).There was no significant difference in the duration of operation,postoperative anal exhaust time and length of hospital stay between the two groups(P>0.05)and the intraoperative blood loss in the follicular phase group was lower than that in the luteal phase group(P<0.01).Compred with those before surgery,Cor,ACTH and NE in both groups were increased at 1 d after surgery(P<0.05),and at 3 d after surgery,Cor,ACTH and NE were decreased,as comared with those at 1 d after surgery(P<0.05).Cor,ACTH and NE in the follicular phase group were lower than those in the luteal phase group at 1 and 3 d after surgery(P<0.05).Compared with those before the operation,E2,FSH and LH in both groups were significantly decreased at 3 months after surgery(P<0.05).At 3 months after surgery,E2,FSH and LH in the follicular phase group were lower than those in the luteal phase group(P<0.01).One case of urinary retention occurred in the luteal phase group after surgery.No other complications such as infection occurred in both groups after surgery.At 6 months after surgery,there was no significant difference in the recurrence rate between the two groups(P>0.05).Conclusion Hysteroscopic endometrial polyp resection during the follicular phase can reduce intraoperative blood loss,alleviate intraoperative stress injury,and improve sex hormone levels.关键词
子宫内膜息肉/宫腔镜/黄体期/卵泡期/子宫内膜厚度/皮质醇/促黄体生成素/复发Key words
endometrial polyps/hysteroscopy/luteal phase/follicular phase/endometrial thickness/cortisol/luteinizing hormone/recurrence引用本文复制引用
李晓美,张娅楠,张欢,田慧珍..黄体期和卵泡期行宫腔镜子宫内膜息肉切除术的有效性与安全性对比分析[J].临床误诊误治,2025,38(17):55-59,5.基金项目
陕西省重点研发计划项目(2023-YBSF-419) （2023-YBSF-419）
