子宫内膜息肉的宫腔镜手术治疗及术后复发的预防效果观察

Hysteroscopy surgery for endometrial polyps and effect of different preventive measures on postoperative recurrence

目的:探讨宫腔镜手术治疗子宫内膜息肉术后复发及术后复发的不同预防措施效果。方法:选取297例子宫内膜息肉患者,行宫腔镜电切术治疗,术后随机分为对照组、安宫黄体酮组及曼月乐组3组,每组99例,观察各组术后复发情况。结果:手术时间、术中出血量、息肉个数3组比较差异均无统计学意义(F=0.75,F=0.11,F=0.96,P>0.05),治疗费用3组比较差异存在统计学意义(F=3.75,P<0.05),各组进行两两比较,安宫黄体酮组与对照组、曼月乐与对照组、安宫黄体酮组与曼月乐组比较,差异均有统计学意义(q=3.74,q=20.35,q=14.91,P<0.05);术后随访1年,子宫内膜息肉复发率对照组为13.54%、安宫黄体酮组为2.04%、曼月乐组为1.05%,随访2年复发率对照组为25.00%、安宫黄体酮组为8.60%、曼月乐组为5.56%,复发率3组比较差异存在统计学意义(1年:χ2=17.71;2年:χ2=17.30;P<0.05),两两比较安宫黄体酮组与对照组、曼月乐组与对照组比较差异存在统计学意义(1年:χ2=8.99,χ2=10.96;2年:χ2=8.79,χ2=13.07;P<0.05)。结论:宫腔镜电切术治疗子宫内膜息肉疗效确切,术后应用激素及曼月乐能明显降低息肉复发,曼月乐效果最佳。

Objective： To explore the surgical treatment of hysteroscopic for endometrial polyp and effect of different preventive measures on postoperative recurrence . Methods： 297 patients with endometrial polyps were treated by hysteroscope electrotomy and divided into control, provera and mann month joy groups （n = 99）. Postoperative recurrence was observed. Results： There were no differences in the operation time, amount of bleeding, intraoperative polyp number among three groups （F = 0. 75, F =0. 11, F = 0. 96, P 〉 0. 05）. There was statistical significant difference in hospital cost among three groups （ F = 3.75, P 〈 0. 05 ） , and between provera and control groups, mann month joy and control groups, provera and mann month joy groups （q = 3.74, q = 20. 35, q = 14. 9l, P 〈 0. 05）. In the follow - up of 1 year, endometrial polyp recurrence rate was 13.54% , 2. 04% and 1.05% in control, provera and mann month joy groups respective- ly. In the follow - up 2 years, recurrence rate was 25.00% , 8.60% , and 5.56% in control, provera and mann month joy groups respective- ly. There was statistical significant difference in recurrence rate among three groups （l years： chi square = 17.71; 2 years： chi square = 17. 30; P 〈0. 05） and between provera and control groups, mann month joy and control groups （1 years： chi square =8. 99, chi - square = 10. 96; 2 years： chi square = 8.79, chi-square = 13.07; P〈 0. 05） . Conclusions： Hysteroscope electrotomy treatment has exact cur- ative effect on endometrial polyps. Application of hormone and mann month joy postoperation can obviously reduce the polyp recurrence and mann month joy is best.