宫腔镜下电切术联合左炔诺孕酮宫内缓释系统治疗子宫肌瘤的效果观察

Clinical effect analysis of hysteroscopic resection combined with Levonorgestrel-releasing intrauterine system in the treatment of uterine fibroids

目的探讨宫腔镜下电切术联合左炔诺孕酮宫内缓释系统(Levonorgestrel-releasing intrauterine system,LNG-IUS,商品名曼月乐)治疗子宫肌瘤的临床效果。方法收集2010年1月至2013年6月在湖北省荆门市第二人民医院收治的72例子宫肌瘤合并月经过多患者的临床资料,按照不同治疗方式分为观察组36例和对照组36例,对照组在宫腔镜下行诊刮术、子宫肌瘤及宫内膜息肉电切术;观察组在对照组的基础上给予LNG-IUS治疗。所有患者治疗后随访1年,对两组月经量、子宫体积及子宫肌瘤复发情况进行比较。结果两组治疗后临床指标均明显改善(P<0.05);观察组治疗后6个月时月经量及子宫体积[(24.4±5.3)m L、(114.5±22.4)cm3]均小于对照组[(38.8±6.4)m L、(135.6±26.5)cm3],血红蛋白浓度[(122.6±8.6)g/L]高于对照组[(98.4±9.2)g/L](均P<0.05);随访1年后,观察组子宫肌瘤复发率(5.56%)低于对照组(27.78%)(P<0.05)。结论宫腔镜下电切术联合LNG-IUS对子宫肌瘤合并月经过多患者疗效良好。

Objective To investigate the clinical effect of hysteroscopic resection combined with Levonorgestrel - releasing intrauterine system （ LNG - IUS ） in the treatment of uterine fibroids. Methods Data of 72 patients with uterine fibroids and menorrhagia in The Second People＇s Hospital of Jingmen from Jan 2010 to Jun 2013 were collected, all cases were divided into two groups with 36 cases in each group according to different treatments. Patients in control group （ n = 36） were given hysteroscopic curettageuterine, fibroids and endometrial polyp eleetrocision under hysteroscopy, and patients in observation group （ n = 36 ） were given LNG - IUS on the basis of treatment of control group. All patients were followed up for 1 year. The menstrual amount, uterine fibroid volume, and recurrence of uterine fibroid between two groups were compared. Results The clinical indicators improved in both group （ P 〈 0.05 ）. After 6 months, menstrual amount [ （24.4 ± 5.3 ） mL ] and uterine volume [ （ 114. 5 ±22.4 ） cm3 ] of observation group were significantly lower than control group [ （38.8 ± 6.4） mL, （ 135.6 ± 26. 5 ） cm3 respectively ], hemoglobin concentration of observation group [ （122. 6 ~ 8.6） g/L] was significantly higher than control group [ （98.4 ± 9. 2 ） g/L ] （P 〈 0. 05 ）. The recurrence rate of uterine fibroids in observation group was 5.56 % after following up for 1 year, which was significantly lower than control group （27.78 % ） （P 〈 0. 05 ）. Conclusion The hysteroscopic resection combined with LNG - IUS has a good effect in the treatment of uterine fibroids.