宫腔镜电切术联合药物治疗子宫内膜息肉的效果观察

Observation on effect of TCRP and gestrinone or gossypol combing treatment in endometrial polyps

目的：观察宫腔镜下子宫内膜息肉电切术（TCRP）后联合药物治疗子宫内膜息肉（EP）的临床疗效。方法：选择2006年3月-2007年3月在新疆医科大学第一附属医院妇科经B超和宫腔镜联合病理检查诊断为子宫内膜息肉的95例患者,行TCRP术,术中切下组织全部送病检。术后随机分为3组：单纯TCRP组30例（对照组）,术后无任何治疗;TCRP术＋孕三烯酮组30例,术后口服孕三烯酮2.5 mg/次,2次/周,共3个月;TCRP术＋醋酸棉酚组35例,术后口服醋酸棉酚20 mg/日,1次/日,共3个月。3组随访时间为3-6个月,观察子宫内膜息肉复发情况。结果：单纯TCRP组术后EP复发11例,TCRP术后口服孕三烯酮组EP复发4例,TCRP术后口服醋酸棉酚组EP复发4例。（1）3组子宫内膜息肉复发概率的差别具有统计学意义（P〈0.05）。（2）单纯TCRP术组与TCRP术后口服孕三烯酮或醋酸棉酚组相比,子宫内膜息肉复发概率的差别具有统计学意义（P〈0.05）。（3）TCRP术后口服孕三烯酮组与TCRP术后口服醋酸棉酚组子宫内膜息肉复发概率的差别无统计学意义（P〉0.05）。结论：子宫内膜息肉电切术后口服孕三烯酮及醋酸棉酚等药物可抑制子宫内膜及残存的子宫内膜息肉,降低子宫内膜息肉的复发率。

Objective： To study effect of TCRP and gestrinone or gossypol combing treatment in endometrial polyps, comparing with TCRP only. Methods： 95 cases of endometrial polyps were randomly devided into three groups. A： 30 cases were treated by TCRP only. B： 30 cases were treated by TCRP combing gestrinone. C： 35 cases were treated by TCRP combing gossypol. The endometriam in all cases was observed by sonography every months and tested by hysteroscopy in the third months. Those whose endometrial polyps did not reccurence, which means the treatment on it was effective. Results： The reccurence of endometrial polyps was 11cases in group A compared 4 cases and 4 cases in group B and C. Among the three groups, there was statistical significance in reccurence of endometrial polyps （P 〈0.05）. The reccurence rate of endometrial polyps in group B and C. is lower than the group A. No significant difference in the reccurence rate of endometrial polyps between the group B and C （P 〉0.05）. TCRP combing gestrinone or gossypol was more effective than TCRP only. Conclutions： It is significant to reduce reccurence rate of endometrial polyps by given gestrinone or gossypol after TCRP.