Feng Li-min, Wang Wei-juan, Zhang Hong-xia, Zhu Yin-zhi
Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing 100050, China.
Zhonghua Fu Chan Ke Za Zhi. 2003 Oct;38(10):611-3.
To investigate the methods of different types of hysteroscopic surgery for endometrial polyps.
A total of 109 cases by different ways by hysteroscopic surgery for endometrial polyp from October 2000 to May 2002 were followed up. The mean age was 45 +/- 9 (26 - 73) years. The mean follow-up was 12 +/- 5 (3 - 22) months. The patients of menstrual disorder were asked for filling in pictorial blood loss assessment chart (PBAC) before and after the surgery.
By the PBAC there was significant difference between before and after the surgery (P = 0.001). After the surgery, among 84 polyps with menstrual disorder, 14 cases (16.7%) were amenorrhea, 26 cases (31.0%) spotting, other 24 cases reducing the amount. Thirty-four cases that had had anemia recovered in one month after the surgery. In 16 cases dysmenorrhea, 7 cases were recovered, 7 got better, and the other 2 got worse. Of 5 cases of infertility (3 were primary and 2 were secondary), 4 cases got pregnancy after the surgery.
The polyp patient who had menstrual disorder without desire of fertility should undergo polypectomy with endometrial resection in order to avoid recurrence. The patient who has desire of fertility should undergo polypectomy merely. If she had polyp with polypoid hyperplasia she should undergo polypectomy with endometrial resection of superficial layer. The postmenopausal patient should perform polypectomy merely or polypectomy with endometrial ablation.
探讨不同类型宫腔镜手术治疗子宫内膜息肉的方法。
对2000年10月至2002年5月采用不同方式行宫腔镜手术治疗子宫内膜息肉的109例患者进行随访。平均年龄为45±9(26 - 73)岁。平均随访时间为12±5(3 - 22)个月。对月经紊乱的患者术前及术后填写图像失血评估表(PBAC)。
根据PBAC,手术前后有显著差异(P = 0.001)。术后,84例月经紊乱的息肉患者中,14例(16.7%)闭经,26例(31.0%)点滴出血,另外24例经量减少。34例贫血患者术后1个月恢复。16例痛经患者中,7例恢复,7例好转,另外2例加重。5例不孕患者(3例原发不孕,2例继发不孕)中,4例术后妊娠。
无生育要求的月经紊乱息肉患者应行息肉切除加子宫内膜切除术以避免复发。有生育要求的患者仅行息肉切除术即可。若合并息肉样增生则应行息肉切除加浅层子宫内膜切除术。绝经后患者仅行息肉切除术或息肉切除加子宫内膜消融术。