宫腔镜电切术联合左炔诺酮宫内缓释系统治疗子宫内膜息肉疗效观察

Observation of the Efficacy of Hysteroscopic Resection Combined with Levonorgestrel Releasing In- trauterine System for the Treatment of Endometrial Polyps

【目的】探讨宫腔镜电切术联合左炔诺酮宫内缓释系统（LNG-IUS）治疗子宫内膜息肉的临床疗效。【方法180例子宫内膜息肉行宫腔镜下子宫内膜息肉电切术的患者随机分为观察组41例，在抗感染同时术后7～10d放置LNG-IuS；对照组39例，按常规术后48h内应用抗生素预防感染。门诊随访2年，记录患者月经改善，不良反应及子宫内膜息肉复发情况。【结果】观察组月经改善有效率为95．12％，显著高于对照组的79．49％，差异有显著性（X2=5．58，P〈0．05）。观察组41例无子宫内膜息肉复发，对照组39例5例复发，复发率为12．82％，差异有显著性（X2=62．16，P〈0．05）。两组不良反应无显著性差异（P〉0．05）。【结论】宫腔镜电切术联合LNG-Ius治疗子宫内膜息肉疗效确切，能有效预防术后复发。

[Objective] To explore the clinical efficacy of hysteroscopic resection combined with levonorgestrel relea- sing intrauterine system（LNG-IUS） for the treatment of endometrial polyps. [Methods] Totally 80 patients with endome- trial polyps undergoing hysteroscopic endometrial polyps transurethral surgery were randomly divided into two groups. The observation group（ n = 41） received anti-infection therapy and the placement of LNG-IUS 7~ 10 days after the opera- tion. The control group（ n = 39） received routine antibiotics for preventing the infection 48h after operation. Outpatients were followed up for 2 years. The improvement of menstruation, adverse reactions and endometrial polyp recurrence of patients were recorded. [Results] The effective rate of menstrual improvement in observation group was 95.12 ~, which was significantly higher than that in control group（79.49 ~）, and there was significant difference（x2 = 5.58, P d0.05）. No endometrial polyp recurrence was found in 41 patients of observation group. The recurrence occurred in 5 patients of 39 patients in control group, and the recurrence rate was 12.82 %, and there was significant difference（z2 ~ 62.16, P 0.05）. There was no significant difference in adverse reactions（ P ]〉0.05）. [Conclusion]Hysteroscopic resection com- bined with LNG-IUS for the treatment of endometrial polyps is effective and can prevent the recurrence after operation.