宫腔镜子宫内膜息肉切除术联合去氧孕烯炔雌醇治疗子宫内膜息肉疗效观察

Therapeutic Effects of Transcervical Resection of Polyp Combined With Marvelon on Endometrial Polyps

目的观察宫腔镜子宫内膜组内切除术(TCRP)联合去氧孕烯炔雌醇治疗子宫内膜息肉(EP)的疗效。方法选择2010年7月至2011年7月于本院门诊拟行TCRP的90例EP患者为研究对象,并按入院顺序随机纳入研究组(TCRP+口服去氧孕烯炔雌醇,n=45)和对照组(TCRP,n=45)。比较两组患者治疗前、后月经情况及术后子宫内膜厚度、EP复发情况(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书)。两组患者年龄、临床症状比较,差异无统计学意义(P>0.05)。结果治疗6个月后,两组患者月经周期恢复正常情况比较,差异有统计学意义(χ2=4.86,P<0.05)。研究组患者月经量减少较对照组更为显著,两组比较,差异有统计学意义(t=3.12,P<0.05)。治疗后两患者子宫内膜平均厚度、EP复发率比较,差异也均有统计学意义(P<0.01)。结论TCRP联合去氧孕烯炔雌醇治疗EP能够有效缓解患者月经周期紊乱及月经量多症状,减少子宫内膜厚度,降低EP复发率。

Objective To evaluate the therapeutic effect of transcervical resection of polyp （TCRP） combined with marvelon on endometrial polyps （EP）. Methods From July 2007 to July 2010,90 women with EP were included in the study,and randomly divided into research group（n=45） and control group（n=45）. Research group accepted TCRP combined with marvelon for treatment,meanwhile control group accepted TCRP for treatment only. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Nanjing Branch Court of Changzheng Hospital Affiliated to Second Military Medical University.Informed consent was obtained from each patient.The menstrual circle recovery,menstrual blood volume before and after treatment, endometrial thickness and polyp relapse rate were compared between two groups. Results 90 patients were successfully complete surgery. There had significant difference in menstrual circle recovery between two groups （χ2=4.86,P0.05）.Research group showed obvious decrease of the menstrual blood volume than that of control group（t=3.12,P0.05）.The endometrial thickness of research group was obviously smaller than that of control group（t=2.55,P0.05）,and the polyp relapse rate was less than that of control group （4.44% vs. 24.44%）（χ2=11.39,P0.01）. Conclusions TCRP combined with marvelon is effective in the treatment of EP, it can effectively improve menstrual disorder, and decrease polyp relapse rate.