宫腔镜联合炔诺酮治疗围绝经期子宫内膜息肉的临床观察

Clinical observation of hysteroscopy combined with norethindrone in the treatment of endometrial polyps for peri-menopausal women

目的探讨宫腔镜联合炔诺酮治疗围绝经期子宫内膜息肉的临床效果与安全性。方法选取2010年1月~2012年6月于柳州市柳铁中心医院妇科就诊的围绝经期子宫内膜息肉患者93例,随机分为研究组47例与对照组46例。研究组行宫腔镜息肉摘除术,术后开始口服炔诺酮2.5 mg/8 h,22天/周期,连续3个周期;对照组行宫腔镜息肉摘除,术后不予其他治疗。两组患者治疗完成后随访6个月,观察患者月经情况、子宫内膜息肉复发情况及子宫内膜厚度等。结果与对照组相比,研究组术后月经异常发生率及子宫内膜息肉复发率明显降低(P<0.05),且研究组子宫内膜厚度明显低于对照组(P<0.05)。结论宫腔镜联合炔诺酮治疗子宫内膜息肉能够明显改善月经异常、降低子宫内膜息肉复发率、抑制子宫内膜过度增生,在围绝经期子宫内膜息肉治疗中疗效满意,安全性较好。

Objective To investigate the clinical effect and safety of hysteroscopy combined with norethindrone in the treatment of endometrial polyps for peri-menopausal women. Methods From January 2010 to June 2012 in Liuzhou city Liutie central hospital gynecology clinic in 93 cases of postmenopausal endometrial polyps, 47 cases were randomly divided into study group and control group of 46 cases. In the study group, 2.5 patients were treated with hysteroscopic polypectomy. The patients were followed by oral administration of levonorgestrel for a period of 3 days（mg/8/h） for a period of 22 days. Two groups of patients were followed up for a period of 6 months after treatment. The patients were followed up by observing the menstruation, the recurrence of endometrial polyps and the thickness of endometrium.Results Compared with the control group, the incidence of abnormal menstruation and endometrial polyp recurrence rate in the study group was significantly lower（P〈0.05）, and the endometrial thickness in the study group was significantly lower than that in the control group（P〈0.05）.Conclusion Hysteroscopy combined with norethindrone could significantly improve the abnormal menstruation, reduce the recurrence rate of endometrial polyps, inhibit endometrial hyperplasia, which possessed a satisfactory efficacy and safety in the treatment of endometrial polyps in peri-menopausal women.