月经过多型排卵性功血子宫内膜的形态学改变及宫腔镜子宫内膜选择性切除的疗效观察

doi:10.3969/j.issn.1671-7171.2017.11.017

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Abstract 【Objective】To investigate the morphology changes of menorrhagia ovulatory dysfunctional uterine patients in hysteroscopy and therapeutic effect of selective endometrial resection.【Methods】From January 2013 to January 2015, 120 cases of menorrhagia DUB patients in our hospital were selected as the observation group, and 80 normal menstrual volunteers were selected as the control group, hysteroscopy was used to observe the endometrial characteristics of the two groupS.After the examination, according to the random number table method, the observation group was divided into treatment group 1 and treatment group 2, 60 cases in each group. The groups 1 was treated with selective endometrial resection under hysteroscopy. And the group 2 was treated with traditional endometrial resection. The therapeutic effect and complication rate of the two groups were observed.【Results】In the observation group, the endometrium showed focal changes, and the average glandular area in irregular zone of endometrium was (l4567. 7 ± 3029. 1) μm², which was significantly higher than that of the control group (9983. 6±3145. 5) μm², and the difference was statistically significant (P<0.05) ; The average density of glandular cells in the irregular endometrium of the observation group was (1.41±0.79) , which was significantly lower than that of the control group (1.89±0.64) , and the difference was statistically significant (P<0.05) ; The cross-sectional area of spiral arterioles in the irregular endometrium was 398. 7 ± 84. μm² in the observation group, which was significantly higher than that in the control group (321.8± 102. 8μm²) , and the difference was statistically significant (P<0.05) . The expression of estrogen receptor (ER) in the irregular endometrium of the observation group was (1.68 ±0.37) points, which was significantly higher than that of the control group (1.36±0.40) , and the difference was statistically significant (P<0.05) . Progesterone receptor (PR) expression score was (1.91±0.32) points, and compared with the control group (1.82 ±0.41) points, the difference was not statistically significant (P>0.05) . The two groups were treated by hysteroscopy, and the effective rate of the group 1 (selective endarterectomy) was 78.33%, the effective rate of the group 2 (traditional surgery) was 90%, and the effective rate of the group 1 was slightly lower than that of the treatment group 2 (χ² = 3.0641, P=0.0800) , but there was no statistical significance. The average operation time, the number of postoperative amenorrhea, and the intrauterine adhesions after 6 months of treatment in the 1 groups were significantly better than those in the treatment group 2, the difference was statistically significant (P<0.05) .【Conclusion】Patients of menorrhagia ovulatory dysfunctional uterine show focal change in hysteroscopy, irregular thickening of endometrium is the main pathological change area causing menorrhagia. Hysteroscopic selective endometrial resection has the same therapeutic effect as traditional surgery, and the postoperative complications are low, which is an effective way to improve the traditional endometrial resection.

Key words： FUNCTIONAL UTERINE BLEEDING Menstruation Hysteroscopy Endometrium/PA Endometrium/SU

Received: 31 July 2017

PACS:

R711.52

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2017.11.017 OR http://www.jcr.net.cn/EN/Y2017/V34/I11/2133

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