曼月乐用于预防子宫内膜息肉电切术后复发的临床观察

Clinical observation of mirena for prevention of post operative recurrence of endometrial polyp resection

目的探讨子宫内膜息肉电切术（TCRP）后应用曼月乐预防息肉复发的效果、依从性及对肝肾功能的影响。方法选择2006年3月至2009年3月在中山市博爱医院妇科行宫腔镜检查＋TCRP并经病理诊断证实的子宫内膜息肉患者218例，随机分为曼月乐组、口服孕激素组和对照组，随访2年，观察子宫内膜息肉复发情况、肝肾功能及依从性。结果曼月乐组放置曼月乐2年后复发率为0％，12服孕激素组为1．25％，对照组为8．57％，曼月乐组与12服孕激素组比较差异无统计学意义（P〉0．05），曼月乐组、12服孕激素组分别与对照组比较，差异有统计学意义（P〈0．05）；曼月乐组依从率为98．48％，12服孕激素组为87．5％，两组比较差异有统计学意义（P〈0．05）；曼月乐组患者中未发现肝肾功能异常，口服孕激素组患者中有6例出现转氨酶升高，与对照组及曼月乐组比较，差异有统计学意义（P〈0．05）。结论子宫内膜息肉电切术后应用曼月乐治疗有助于预防子宫内膜息肉的复发，对肝肾功能无影响，不良反应小，依从性高。

Objective To investigate the effect of mirena on prevention of polyp recurrence of transcervical resection of endometrial polyp（TCRP） and its compliance application and effect on liver and kidney function. Methods Two hundred and eighteen cases of endometrial polyps diagnosed by hyste- roscopy combined with TCRP and pathologicall confirmed in boai hospital of zhongshan from March 2006 to March 2009 were randomly divided into three groups, the mirena group, oral progesterone group and control group. The follow-up time was 2 years, and the recurrence of endometrial polyps, liver and kid- ney function, and compliance were observed. Results The recurrence rate was 0% in mirena group after the patients were placed with mirena for two years, 1.25% in the oral progesterone group 2 years after operation and 8.57% in the control group ,there was no significant difference between mirena group and oral progesterone group （ P 〉 0. 05 ）. The mirena group and the oral progesterone group respectively com- pared with the control group, the differences were significant （ P 〈 0. 05 ）. The compliance rate of mirena group（98.48% ）was obviously higher than that of the oral progesterone group（87.5% ）, the differences were significants （ P 〈 0. 05 ）. There was no abnormal liver and kidney function in mirena group, six ca- ses of elevated transaminase were found in oral progesterone group, there were significant differences by respectively compared with the control group and the Mirena group （ P 〈 0.05 ）. Conclusions Mirena has no influence on the liver and kidney function, little side effect and high compliance for prevention of polyp recurrence of transcervical resection of endometrial polyp.