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目的观察宫腔镜下电切术配合球囊压迫止血治疗子宫内膜息肉的效果。方法选择2015年2月—2016年4月收治的子宫内膜息肉患者92例,随机分为观察组与对照组,每组各46例。两组均行宫腔镜下电切术治疗,术中观察组行球囊压迫止血,对照组行电凝止血。对比观察两组术中出血量、手术时间、术后渗血时间、术后出血量;手术结束时检测检测两组应激状态指标:促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)、皮质醇(cortisol,Cor)、去甲肾上腺素(norepinephrine,NE)水平;血流动力学指标:心输出量(cardiac output,CO)、平均动脉压(mean arterial pressure,MAP)、每搏量(stroke volume,SV)。计量资料比较采用t检验,P<0.05为差异有统计学意义。结果观察组手术时间、术后渗血时间、术中出血量[(31.06±5.28)min、(1.60±0.21)d、(16.38±2.35)ml]均少于对照组[(52.71±6.65)min、(2.98±0.40)d、(29.03±4.11)ml],比较差异有统计学意义(均P<0.05)。手术结束时观察组ACTH、Cor、NE水平[(44.06±6.03)pg/ml、(125.03±15.34)、(113.06±16.03)ng/ml]均低于对照组[(80.25±8.64)pg/ml、(197.03±20.36)、(200.25±30.42)ng/ml],比较差异有统计学意义(均P<0.05)。手术结束时,观察组CO、MAP、SV[(3.87±0.44)l/min、(86.03±10.30)mm Hg、(53.00±6.09)ml]均低于对照组[(5.89±0.76)l/min、(112.08±12.84)mm Hg、(74.05±7.64)ml],比较差异有统计学意义(均P<0.05)。结论宫腔镜下电切术配合球囊压迫止血治疗子宫内膜息肉比电凝止血效果好,可缓解应激反应,血流动力学稳定。
Objective To observe the effect of hysteroscopic resection combined with balloon compression to treat endometrial polyps. Methods 92 patients with endometrial polyps who were admitted from February 2015 to April 2016 were randomly divided into observation group and control group with 46 cases in each group. Hysteroscopic resection was performed in both groups. The intraoperative observation group underwent balloon hemostasis while the control group received electrocautery to stop bleeding. The amount of blood loss, operation time, postoperative bleeding time and postoperative bleeding volume were compared between the two groups. At the end of the operation, the stress state indexes of adrenocorticotropic hormone (ACTH), cortisol (Cor) and norepinephrine (NE). The hemodynamic parameters included cardiac output (CO), mean arterial pressure (MAP), stroke volume (SV) ). Measurement data were compared using t test, P <0.05 for the difference was statistically significant. Results The operation time, postoperative bleeding time, intraoperative blood loss (31.06 ± 5.28) min, (1.60 ± 0.21) d and (16.38 ± 2.35) ml in the observation group were less than those in the control group [(52.71 ± 6.65) min , (2.98 ± 0.40) d, (29.03 ± 4.11) ml respectively), the differences were statistically significant (all P <0.05). The levels of ACTH, Cor and NE in the observation group [(44.06 ± 6.03) pg / ml, (125.03 ± 15.34) and (113.06 ± 16.03) ng / ml] were lower than those in the control group [(80.25 ± 8.64) pg / , (197.03 ± 20.36) and (200.25 ± 30.42) ng / ml, respectively, with statistical significance (all P <0.05). At the end of the operation, the CO, MAP and SV [(3.87 ± 0.44) l / min, (86.03 ± 10.30) mm Hg and (53.00 ± 6.09) ml] , (112.08 ± 12.84) mmHg, (74.05 ± 7.64) ml respectively), the differences were statistically significant (all P <0.05). Conclusion Hysteroscopic resection with balloon compression hemostasis treatment of endometrial polyps better than coagulation hemostasis can relieve stress response, hemodynamic stability.