宫腔镜电切术后不同方案预防子宫内膜息肉复发疗效分析

Prognostic analysis of different strategy to prevent the reoccurrence of endometrial polyps after hysteroscopy

目的：分析宫腔镜电切术（TCRP）后不同方案预防子宫内膜息肉复发的临床疗效及预后。方法选择子宫内膜息肉TCRP术后患者116例，按术后治疗方案不同分为A、B、C 3组，A组47例患者在月经后4～7 d时安置左炔诺孕酮宫内缓释系统，B组44例患者口服去氧孕烯炔雌醇周期治疗，C组25例患者未行后续治疗，随访1年，比较3种方案临床效果及预后。结果 A、B、C组治疗总有效率分别为96％、77％、40％；A 组无一例复发，B、C 组复发率分别为18％、52％。TRCP术后使用3种方案的子宫内膜息肉患者的临床疗效及息肉复发情况比较差异均有统计学意义（P均＜0.01）。A组患者治疗后月经量明显减少，内膜厚度明显下降（P均＜0.01）。结论子宫内膜息肉手术后采用后续治疗预防复发是有必要的，其中放置左炔诺孕酮宫内缓释系统较口服避孕药疗效更佳。

Objective To evaluate three different strategie for preventing the reoccurrence of endom-etrial polyp after hysteroscopy. Methods 1 1 6 cases of endometrial polyp after hysteroscopy were divided into three groups （A,B and C）by different treatments after operation. Patients in group A （n=47 ）were given levonorgestrel intrauterine slow-release system;patients in group B （n=44） were given oral contraceptive pill （marvelon）and patients in group C （n=25 ） weren＆#39;t given any post operative treatment. The follow up period of all cases were more than 1 2 months. Results The total effective rate in group A,B and C was 96%,77%and 40%respectively （P〈0.01 ）. The total reoccurrence rate in group A,B and C was 0,1 8%and 52%re-spectively （P〈0.01 ）. The clinical effect and reoccurrence rate of these three methods after TRCP were sig-nificantly different （P〈0.01 ）. The amount of menstrual bleeding and thickness of endometrium were de-creased signicantly in group A （P〈0.01 ）. Conclusion Treatment after hysteroscopy for endometrial polyp is necessary which would decrease the reoccurrence. The levonorgestrel intrauterine slow-release system has better effects than oral contraceptive pills.