Clinical Analysis Of Hysteroscopic Cryosurgery And Electrosurgery In The Treatment Of Endometrial Polyps

Objective: the purpose of this study is to compare the clinical effect of hysteroscopic cold knife and electrosurgical knife in the treatment of endometrial polyps,so as to provide theoretical basis for the selection of clinical treatment methods of endometrial polyps.Methods: from September 2017 to February 2019,60 cases of endometrial polyps were diagnosed by transvaginal ultrasound and hysteroscopy in the gynecology department of Jilin People’s hospital.The intraoperative conditions of patients were recorded,including the statistics of operation time,intraoperative hemorrhage,intraoperative use of distended fluid and hospitalization days.The follow-up of patients was recorded,including the statistics of postoperative complications,symptom improvement,recovery of uterine cavity and recurrence of endometrial polyps.Spss26.0 statistical software was used to analyze,t test was used to measure the data,x2 test was used to count the data,and P < 0.05 was used as the standard to think the difference was statistically significant.Result:1.Intraoperative condition The mean time of operation in the cold knife resection group was(20.93 ± 3.65)min,the mean time of operation in the electric knife resection group was(33.10 ± 3.79)min,P <0.05,the difference between the two groups was statistically significant;the intraoperative blood loss in the cold knife resection group was(21.89 ± 4.40)ml,the intraoperative blood loss in the electric knife resection group was(22.39 ± 4.81)ml,P <>0.05,there are no difference between the two groups was statistically significant.The absorption of distended fluid was(267.95 ± 70.95)ml in the scalpel group and(388.36 ± 80.59)ml in the electrosurgical group.There was a significant difference between the two groups(P =0.000).There was no significant difference between the two groups.2.Follow up One week follow-up showed that there were 3 cases of postoperative abdominal pain in the cold knife treatment group and 14 cases in the electric knife treatment group,all of which were relieved by themselves in 3-5 days without postoperative infection.The difference between the two groups was statistically significant(P < 0.05).After the treatment of endometrial polyps with two kinds of surgical methods,vaginal drainage occurred.The average vaginal drainage in the cold knife treatment group was(5.33 ± 0.83)days,and the average vaginal drainage in the electric knife treatment group was(8.09 ±1.74)days,P < 0.05.There was statistically significant difference between the two groups.One month after the operation,hysteroscopy showed that there were 4 cases of intrauterine adhesions in the two groups,all of them were from the electrosurgical treatment group.There was a significant difference between the two groups(P < 0.05).After 3 months of hysteroscopy,25 patients had endometrial coverage of more than 3 /4 of the wounds,all of them were pink in color,26 patients had smooth endometrial surface and no intrauterine adhesions;23 patients in the electrosurgical resection group had endometrial coverage of more than 3 / 4 of the wounds,7 patients had gray white endometrial,10 patients had rough endometrial surface,and 4 patients had intrauterine adhesions.There was significant difference between the two groups(P < 0.05).After 1 year follow-up,6 cases recurred in 60 patients,2 in the cold knife group and 4in the electric knife group.The recurred patients were all multiple polyps,there was no significant difference between the two groups(P = 0.863).There were 15 patients with fertility requirements in the cold knife treatment group,10 of them were pregnant naturally,4 of them were pregnant after in vitro fertilization and embryo transfer(IVF-ET),20 of them were pregnant naturally,5 of them were pregnant naturally,5 of them were pregnant after IVFET,,10 of them were not pregnant.There was significant difference between the two groups(P = 0.018)..Conclusion: 60 cases of endometrial polyps were treated by different ways of operation.The results were as follows:1.Hysteroscopic cryosurgery for endometrial polyps can effectively shorten the operation time,reduce the absorption of swelling fluid.2.Hysteroscopic cryosurgery for endometrial polyps can effectively reduce the incidence of abdominal pain,and shorten the time of vaginal drainage compared with electrotomy.3.Compared with hysteroscopic electrosurgical treatment,hysteroscopic cold knife treatment of endometrial polyps reduces the incidence of postoperative intrauterine adhesions.For the patients with pregnancy requirements,cold knife treatment of endometrial polyps is more conducive to endometrial recovery and reduce intrauterine adhesions,which is more suitable than electrosurgical resection.