宫腔镜手术联合黄体酮胶囊诊治子宫内膜息肉的临床分析

Clinical Analysis of Hysteroscopic Surgery Combined with Progesterone Capsules for Treatment of Endometrial polyps

目的探讨宫腔镜手术联合黄体酮胶囊诊治子宫内膜息肉的临床疗效。方法回顾性的分析我院2009年1月至2013年6月收治的258例子宫内膜息肉患者,所有患者是采用宫腔镜检查发现子宫内膜息肉转行宫腔镜子宫内膜息肉电切术同时予行诊刮术,术中电切出组织及刮出组织全部送病理检查。经病理确诊为子宫内膜息肉者随机分为两组,对照组122例为单纯行子宫内膜息肉电切术组;研究组136例为子宫内膜息肉电切术加服黄体酮胶囊组。比较分析两组的治疗效果。结果对照组复发率13.12%(16/122);异常子宫出血发生率20.49%(25/122);研究组复发率3.68%(5/136);异常子宫出血发生率5.15%(7/136)。两组比较有显著差异性。子宫内膜息肉不孕症患者25例行宫腔镜检查及宫腔镜子宫内膜息肉电切术后联合黄体酮胶囊治疗后19例成功妊娠。宫腔镜诊断与病理诊断比较符合率为91.5%。结论 1宫腔镜诊断和治疗子宫内膜息肉有较高的临床价值;2宫腔镜子宫内膜息肉电切术后应用黄体酮胶囊可以抑制子宫内膜局部过度增生,改善症状和降低子宫内膜息肉的复发;可以提高子宫内膜息肉导致不孕患者的生育能力。值得临床推广应用。

Objeetive To evaluate the clinical efficacy of hysteroscopie surgery combined with progesterone capsules for treatment of endometrial polyps. Methods In the retrospective analysis of our hospital from January 2009 to June 2013 were treated 258 cases of endometrial polyps, all patients were found using hysteroscopy switch hysteroscopic endometrial.polyp resecelectrosurgical excision procedure and scraped tissue were sent to pathology. Pathologically diagnosed as endometrial polyps were randomly divided into two groups, 122 cases in the control group were with electrosurgical excision procedure of endometrial polyps; 136 cases in the study group were with endometrial polyp by electrosurgical excision procedure and progesterone capsules. Comparative and analysis of treatment effects between the two groups. Result The recurrence rate in the control group was 13.12% （16/122）, the incidence of abnormal uterine bleeding was 20.49%（25/122）, Study group relapse rate was 3.68%（5/136）, the incidence of abnormal uterine bleeding was 5.15%（7/136）, Both groups had significant differences. Infertility 25 endometrial polyps after routine hysteroscopy and hysteroscopic resection of endometfial polyps with capsule in treating 19 cases of progesterone successful pregnancy. Diagnostic hysteroscopy more in line with the pathological diagnosis was 91.5%. Conclusion （1） Hysteroscopie diagnosis and treatment of endometrial polyps have a higher clinical value; （2）Hysteroseopic resection of endometrial polyps application of progesterone capsules can suppress endometrial byperplasia local, improve symptoms and reduce the recurrence of endometrial polyps; improve the fertility of endometrial polyps cause infertility patients. It deserves to be applied in clinical practice.