目的 探究不同宫腔镜手术治疗子宫内膜息肉合并异常子宫出血的远期效果,分析宫腔镜下冷刀切除术对患者子宫动脉血流参数、血红蛋白的影响,为临床提高疗效提供新思路。方法 选取2020年1月—2023年6月收治的80例子宫内膜息肉伴异常子宫出血患者,按随机数字表法分为参照组与研究组（各40例）,分别实施宫腔镜下电切术和宫腔镜下冷刀切除术。对比两组患者手术前后子宫内膜厚度、子宫动脉血流参数以及血红蛋白水平;术后随访6个月,统计两组术后并发症发生率、子宫内膜息肉复发率、异常子宫出血发生率。结果 术后1、3、6个月,研究组患者子宫内膜厚度小于参照组（P<0.05）。术后6个月,研究组血流阻力指数、搏动指数低于参照组,血红蛋白水平高于参照组（P<0.05）。研究组术后并发症发生率为5.00%,低于参照组的22.50%,差异具有统计学意义（P<0.05）。研究组术后子宫内膜息肉复发率、异常子宫出血发生率低于参照组（P<0.05）。结论 实施宫腔镜下子宫内膜息肉冷刀切除术可有效减少子宫内膜增生,改善子宫血液循环,恢复血红蛋白水平,且术后并发症较少,预防子宫内膜息肉和异常子宫出血复发的远期疗效较理想。

Objective To explore the long-term effects of different hysteroscopic surgeries in the treatment of endometrial polyps combined with abnormal uterine bleeding, analyze the effect of hysteroscopic cold knife resection on uterine arterial blood flow parameters and hemoglobin in patients, and provide new ideas for improving clinical efficacy. Methods According to the random number table method, 80 patients with endometrial polyps and abnormal uterine bleeding admitted from January 2020 to June 2023 were divided into a reference group and a study group （40 cases in each group）, and hysteroscopic electroresection and hysteroscopic cold knife resection were performed respectively. Endometrial thickness, uterine arterial blood flow parameters, and hemoglobin levels before and after surgery were compared between the two groups. The patients were followed up for 6 months after surgery, and the incidence rates of postoperative complications, recurrence of uterine polyps, and abnormal uterine bleeding in the two groups were recorded. Results At 1, 3, and 6 months after surgery, the patients in the study group had less endometrial thickness than the reference group （P<0.05）. At 6 months after surgery, the blood flow resistance index （RI） and pulsatility index （PI） of the study group were lower than those of the reference group, and the hemoglobin level was higher （P<0.05）. The postoperative complication rate in the study group was 5.00%, which was lower than 22.50% in the reference group, and the difference was statistically significant （P<0.05）. The recurrence rate of postoperative endometrial polyps and the incidence rate of abnormal uterine bleeding were lower in the study group than in the reference group （P<0.05）. Conclusion Hysteroscopic cold knife resection of endometrial polyps can effectively reduce endometrial hyperplasia, improve uterine blood circulation, restore hemoglobin level, and have fewer postoperative complications, so the long-term effect on preventing recurrence of endometrial polyps and abnormal uterine bleeding is ideal.