育龄女性子宫内膜息肉经宫腔镜电切手术前后药物干预的临床观察

Clinical observation on drug intervention before and after hysteroscopic endometrial polyps operation among women of childbearing age

目的观察育龄期女性子宫内膜息肉经宫腔镜电切治疗前、后应用优思明干预和预防术后复发的临床疗效。方法选择经宫腔镜检查诊断为子宫内膜息肉的育龄已婚女性78例随机分为A、B、C 3个组,A组术前服用优思明3个周期,手术结束后继续应用优思明3个周期共6个周期;B组入院即行手术治疗,术后口服优思明3个周期;C组为对照组,手术前、后均无任何干预措施,术后常规消炎止血。3个组患者术后电话及门诊随访12个月,观察比较3种治疗方式对患者的月经情况及术后子宫内膜厚度、EP的复发情况以及妊娠情况。结果 A组月经恢复显效率及总有效率均高于B组和C组,A和B组、B和C组比较差异有统计学意义(P<0.05);子宫内膜厚度术前A组较薄,术后第3、6、12个月子宫内膜厚度A组较B组薄,B组较C组薄,差异均有统计学意义(P<0.05);A组及B组息肉的复发率较低,与C组比较差异有统计学意义(P<0.05),3个组妊娠率比较差异无统计学意义(P>0.05)。结论宫腔镜下子宫内膜息肉电切手术前、后应用优思明干预可有效恢复月经周期和经量情况并减少复发,且6个月治疗时间疗效优于3个月治疗时间,值得临床推广应用。

Objective To observe the clinical efficacy of Yasmin used before and after hysteroscopic endometrial polyps operation among women of childbearing age in intervention and prevention of postoperative recurrence. Methods Seventy-eight married women of childbearing age who were diagnosed as endometrial polyps by hysteroscopy were selected and randomly divided into group A, group B, and group C. The patients in group A were treated by Yasmin for three courses of treatment, after operation, the patients in group A were treated by Yasmin continuously for three courses of treatment. The patients in group B were treated by surgery, after operation, the patients in group B were treated by Yasmin for three courses of treatment. The patients in group C （control group） were not treated by any intervention meas- ures before and after operation, after operation, anti-inflammation and hemostasis were given to them. The patients in the three groups were followed up for 12 months after oepration through telephone and at outpatient. The menstrual situations, postoperative endometrial thickness, recurrence rate of endometrial polyps, and pregnancy rates in the three groups were observed and compared. Results The significant effective rate of menstrual recovery and total effective rate in group A were higher than those in group B and group C, there were statistically significant differences between group B and group A, group C, respectively （P〈 0. 05） . Before operation, endometrial thickness in group A was thin; at 3, 6, and 12 months after operation, endometrial thicknesses in group A were thinner than those in group B, endometrial thickness in group B was thinner than that in group C, there were statistically significant differences （ P〈0. 05 ） . The recurrence rates of endometrial polyps in group A and group B were low, compared with group C, there were statistically significant differences （ P〈0. 05 ） . There was no statistically significant difference in pregnancy rate among the three groups （ P〉0.05 ） . Conclusion Yasmin intervention before and after hysteroscopic endometrial polyps operation among women of childbearing age can effectively restore menstrual cycle and volume, and reduce the recurrence; the curative effect of Yasmin used for six months is better than that of Yasmin used for three months, which is worthy of clinical promotion and application.