Abstract:

Objective　To explore the impact of hysteroscopic endometrial resection on endometrial thickness and sex hormones in patients with abnormal uterine bleeding. Methods　One hundred and thirty patients with abnormal uterine bleeding treated at First Hospital, Northwest University from March 2020 to March 2023 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 65 cases in each group. The control group were (41.18±4.00) years old; their disease course was (15.00±3.58) months. The observation group were (41.55±4.44) years old; their disease course was (14.38±3.82) months. The control group underwent traditional curettage surgery, and the observation group hysteroscopic endometrial electrosurgical resection. The surgical indicators, the endometrial thicknesses, menstrual volumes, and sex hormone levels before and 6 months after the surgery, and the incidences of adverse reactions were compared between the two groups by χ² and t tests. Results　The time to first flatus, time to off bed activity, and hospital stay in the observation group were shorter than those in the control group [(4.35±0.85) h vs. (7.43±1.82) h, (8.73±1.52) h vs. (28.93±3.45) h, and (4.15±1.15) d vs. (7.43±1.96) d], with statistical differences between the two groups (t=12.362, 43.198, and 11.637; all P<0.001). Before the treatment, there were no statistical differences in endometrial thickness, menstrual volume, and sex hormone levels between the two groups (all P>0.05). Six months after the treatment, endometrial thickness, menstrual volume, and levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol (E2) in the observation group were better than those in the control group [(6.63±1.33) mm vs. (7.65±1.35) mm, (91.20±6.83) ml vs. (101.45±9.82) ml, (9.28±2.45) IU/L vs. (17.89±3.35) IU/L, (6.30±1.40) IU/L vs. (16.09±4.16) IU/L, and (69.03±6.13) pmol/L vs. (59.30±5.85) pmol/L], with statistical differences (t=4.339, 6.909, 16.726, 17.982, and 9.258; all P<0.009). The incidence of adverse reactions in the observation group was lower than that in the control group [3.08% (2/65) vs. 16.92% (11/65)], with a statistical difference (t=6.923; P=0.009). Conclusion　Hysteroscopic endometrial resection for patients with abnormal uterine bleeding can effectively reduce their endometrial thickness and menstrual volume and adverse reactions, and does not affect their sex hormone levels, so it is a safe and effective treatment option.

Key words:

Abnormal uterine bleeding, Hysteroscopic endometrial resection, Endometrial thickness, Sex hormones

摘要：

目的　探讨宫腔镜子宫内膜电切术对异常子宫出血患者子宫内膜厚度及性激素的影响。方法　选取2020年3月至2023年3月西北大学第一医院收治的130例异常子宫出血患者，通过随机数字表法分为对照组与观察组，各65例。对照组患者年龄（41.18±4.00）岁，病程（15.00±3.58）个月，予以传统刮宫术治疗；观察组患者年龄（41.55±4.44）岁，病程（14.38±3.82）个月，予以宫腔镜子宫内膜电切术治疗。比较两组患者的手术相关指标，治疗前与治疗6个月后的子宫内膜厚度、月经量、性激素水平及不良反应发生情况。采用χ²检验、t检验进行统计分析。结果　观察组肛门排气时间为（4.35±0.85）h、下床活动时间为（8.73±1.52）h、住院时间为（4.15±1.15）d，对照组分别为（7.43±1.82）h、（28.93±3.45）h、（7.43±1.96）d，两组比较差异均有统计学意义（t=12.362、43.198、11.637，均P<0.001）。治疗前，两组患者的子宫内膜厚度、月经量、性激素水平比较差异均无统计学意义（均P>0.05）。治疗6个月后，观察组患者子宫内膜厚度为（6.63±1.33）mm，月经量（91.20±6.83）ml，对照组分别为（7.65±1.35）mm、（101.45±9.82）ml，差异均有统计学意义（t=4.339、6.909，均P<0.001）；观察组黄体生成素（LH）为（9.28±2.45）IU/L、卵泡刺激素（FSH）为（6.30±1.40）IU/L、雌二醇（E2）为（69.03±6.13）pmol/L，对照组分别为（17.89±3.35）IU/L、（16.09±4.16）IU/L、（59.30±5.85）pmol/L，两组比较差异均有统计学意义（t=16.726、17.982、9.258，P<0.001）；观察组不良反应发生率为3.08%（2/65），低于对照组的16.92%（11/65），差异有统计学意义（t=6.923，P=0.009）。结论　宫腔镜子宫内膜电切术治疗可有效降低异常子宫出血患者的子宫内膜厚度和月经量，不影响患者的性激素水平，不良反应发生率低，是一种更安全、有效的治疗选择。

关键词:

异常子宫出血, 宫腔镜子宫内膜电切术, 子宫内膜厚度, 性激素