Analysis of the Therapeutic Efficacy of Hysteroscopic Electric Resection in the Treatment of Atypical Endometrial Hyperplasia and Factors Influencing Prognosis.

OBJECTIVE

The objective of this study was to evaluate the efficacy of hysteroscopic electroresection in the treatment of atypical endometrial hyperplasia and to determine the prognostic factors.

METHODS

226 patients with endometrial dysplasia treated in hospital from January 2021 to August 2022 were selected and divided into control group (113 cases) and study group (113 cases) according to different treatment methods selected by the patients themselves. The control group received curettage plus conventional progesterone treatment, while the study group received hysteroscopic electroresection plus conventional progesterone treatment. After 6 months of treatment, the clinical efficacy (complete response, partial response and progress) of the two groups were evaluated, complications and adverse drug reactions of the two groups were analyzed, and estrogen levels before and after treatment were compared between the two groups. After 1 year follow-up, patients were divided into relapse group and non-recurrence group according to whether they had relapse or not. Clinical data of the two groups were compared to analyze the related factors affecting the prognosis of patients.

RESULTS

(1) Chi-square test results showed that the total effective rate of the study group was higher (96.46% VS 77.88%) than that of the control group (P < .05). The complication rate and recurrence rate of the study group were lower than those of the control group (1.77% VS 7.96%, 4.42% VS 21.24%) (P < .05). (2) t test results of independent samples showed that after 6 months of treatment, the levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in the study group were lower than those in the control group (P < .05); (3) The t test results of independent samples indicated that the age and body mass index of the relapsed group were higher than those of the non-relapsed group (P < .05); Chi-square test results showed that the proportion of diabetes was higher than that of the group without recurrence, and the proportion of hysteroscopic electroresection was lower than that of the group without recurrence (P < .05). (4) Logistic regression model was established, and the results showed that age (OR=1.159), body mass index (OR=1.529) and diabetes (OR=3.861) were the risk factors for prognosis of patients with endometrial dysplasia (P < .05), and hysteroscopic electroresection was the protective factor (OR < 1, P < .05).

CONCLUSION

Hysteroscopic electroresection shows significant potential in the treatment of atypical hyperplasia of endometrial, and can improve clinical efficacy and reduce complications by effectively regulating estrogen secretion. In addition, studies have shown that the prognosis of endometrial dysplasia may be related to the age of patients, body mass index and diabetes mellitus. Therefore, for patients with the above risk factors, early consideration of hysteroscopic electrotomy therapy is recommended to reduce recurrence rates and provide important informational support for treatment protocols and clinical guidelines.