宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗子宫内膜息肉临床观察

Clinical effects of transcervical resection of myoma combined with levonorgestrel-releasing intrauterine system in treatment of endometrial polyps

目的探讨宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗子宫内膜息肉临床效果。方法选择2016年2月‐2017年2月该院收治的子宫内膜息肉患者170例作为研究对象,将所有患者随机分为观察组与对照组,各85例。对照组行宫腔镜电切术治疗,观察组行宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗,比较两组患者子宫内膜厚度、血清雌二醇(E2)、孕酮(P)水平与月经量变化情况以及术后子宫内膜息肉复发率。结果术前与术后1个月两组患者子宫内膜厚度相比,差异无统计学意义(P>0.05),观察组患者在术后3、6个月子宫内膜厚度均低于对照组,差异有统计学意义(P<0.05);术前术后两组患者E2、P水平相比,差异均无统计学意义(P>0.05);术前两组患者月经量相比,差异无统计学意义(P>0.05),观察组患者在术后1、3、6个月月经量均少于对照组,差异有统计学意义(P<0.05);术后观察组子宫息肉复发率低于对照组,差异有统计学意义(P<0.05)。结论宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗子宫内膜息肉可有效减少患者子宫内膜厚度与月经量,降低术后内膜息肉复发率。

【Objective】To investigate the clinical effects of transcervical resection of myoma（TCRM） and levonorgestrelreleasing intrauterine system（LNG-IUS） in treatment of endometrial polyps.【Methods】A total of 170 patients with endometrial polyps admitted in our hospital from February 2016 to February 2017 were randomly divided into observation group and control group, 85 cases in each group. Control group was given TCRM, while observation group was treated with TCRM and LNG-IUS. The endometrial thickness, estradiol（E2）, progesterone（P）, changes of menstrual amount, and recurrence rate of endometrial polyps were compared between the two groups.【Results】Before surgery and 1 month after surgery, there was no statistical difference in the endometrial thickness between the two groups（P〉0.05）; 3 and 6 months after surgery, the endometrial thickness of observation group was lower than that of control group（P〈0.05）. Before and after surgery, there was no statistical difference in the levels of E2 and P between the two groups（P〉0.05）. Before surgery, there was no statistical difference in the menstrual amount between the two groups（P〉0.05）; 1, 3, 6 months after surgery, the menstrual amount of observation group was less than that of control group（P〈0.05）. After surgery, the recurrence rate of endometrial polyps in observation group was lower than that in control group（P〈0.05）.【Conclusion】TCRM combined with LNG-IUS in treatment of endometrial polyps can reduce the endometrial thickness and menstrual amount, and decrease the recurrence rate of endometrial polyps.