宫腔镜下电切术联合药物控释性节育环治疗子宫肌瘤的疗效观察

Treatment efficacy of uterine fibroids under hysteroscopic surgery combined with drug controlled release contraceptive ring

目的探讨宫腔镜下电切术联合药物控释性节育环治疗子宫肌瘤的疗效。方法选择黏膜下子宫肌瘤且需要行宫腔镜下切除术的患者共88例,分为两组,其中研究组使用宫腔镜下电切术联合药物控释性节育环治疗(n=38),对照组仅采用宫腔镜下电切术(n=50)。收集两组的一般资料,包括年龄、病程、月经量、肌瘤平均直径等,比较两组治疗前与治疗后3个月、6个月时月经量、子宫大小与血红蛋白浓度,并随访1年,观察子宫肌瘤复发情况。结果两组在年龄、病程、月经量、血红蛋白浓度、肌瘤直径、分型与是否多发的比较中均无统计学差异(P<0.05)。治疗后6月较治疗后3月两组患者的月经量、子宫大小均有明显减少,血红蛋白浓度有明显提高(t=4.482~7.432,P<0.05)。在治疗后3个月和治疗后6个月,研究组病人的月经量、子宫体积明显小于对照组,血红蛋白浓度明显比对照组高,差异明显具有统计学意义(P<0.05)。1年后随访,研究组复发率(1例,2.6%)明显低于对照组(5例,10.0%),差异有显著性(P<0.05)。结论宫腔镜下电切术联合药物控释性节育环治疗子宫肌瘤可有效减少患者的月经量,纠正贫血,缩小子宫体积,并显著降低了子宫肌瘤的复发率,具有较好的治疗效果。

Objective To investigate the treatment efficacy of uterine fibroids under hysteroscopic surgery combined with drug controlled release contraceptive ring. Methods A total of 88 cases of patients with uterine fibroids undertaken hysteroscopic myomectomy were collected.They were divided into two groups： the study group and the control group. In the study group,hysteroscopic surgery combined with drug controlled release contraceptive ring was performed（ n = 38）. In the control group,only electrical hysteroscopic resection was performed（ n = 50）. General information was collected,including age,disease duration,the amount of menstruation,fibroids mean diameter,etc. Before and 3,6 months after treatment,menstrual flow,uterine size and hemoglobin concentration were compared. In 1- year follow- up observation,uterine fibroids recurrence was observed. Results There was no difference between the two groups in age,disease duration,the amount of menstruation,fibroids diameter,type and whether multiple. Menstrual flow,uterine size were decreased 3,6 after treatment compared with control group,hemoglobin concentration were increased（ t = 4. 482- 7. 432,P〈0. 05）. Menstrual flow,uterine size of the study group were significantly smaller than those of the control group,hemoglobin concentration was significantly higher in the study group than that in the control group. After one year follow- up,the relapse rate（ 1 case,2. 6%） of the study group was significantly lower than that of the control group（ 5 cases,10. 0%）,the difference was significant（ P〈0. 05）. Conclusion Treatment of Hysteroscopic surgery combined with drug controlled release contraceptive ring in uterine fibroids can effectively reduce menstrual flow,correction of anemia and uterine volume,and significantly reduce the recurrence rate of uterine fibroids,which has a better therapeutic effect.