不同方案预防宫腔镜电切术后子宫内膜息肉复发的疗效分析

Therapeutic Effects of Different Regimens for Prevention of Recurrence of Endometrial Polyps After Hysteroscopic Resection

目的探讨不同方案预防宫腔镜电切术后子宫内膜息肉复发的疗效。方法以2016年1月至2017年12月在我科接受宫腔镜引导下息肉切除术的患者50例为研究对象,所有患者术后病理均被证实为子宫内膜息肉。50例患者根据不同的治疗方法分为三组,A组(10例)术后不采用任何方式预防子宫内膜息肉复发,B组(20例)术后口服去氧孕烯炔雌醇6个月,C组(20例)术后宫内放置左炔诺孕酮缓释系统。比较三组患者术后1年的子宫内膜息肉复发率。结果术后1年,A组的复发率为30.0%,B组的复发率为5.0%,C组的复发率为0.0%,三组的复发率比较,差异有统计学意义(P<0.05)。结论去氧孕烯炔雌醇和左炔诺孕酮缓释系统均可有效抑制子宫内膜息肉的复发,左炔诺孕酮缓释系统的疗效最佳,但是不适用于有生育要求的患者。

Objective To investigate the therapeutic effects of different regimens in preventing recurrence of endometrial polyps after hysteroscopic resection. Methods 50 patients with hysteroscopic-guided polypectomy in our department from January 2016 to December2017 were selected as study objects. All patients were pathologically confirmed as endometrial polyps after operation. 50 patients were divided into three groups according to different treatment methods. Group A(10 cases) did not use any way to prevent the recurrence of endometrial polyps after operation;Group B(20 cases) received oral deoxygestrel estradiol for 6 months after operation;Group C(20 cases)received intrauterine levonorgestrel sustained-release system after operation. The recurrence rate of endometrial polyps was compared among the three groups one year after operation. Results One year after operation, the recurrence rate was 30.0% in group A, 5.0% in group B and0.0% in group C, with statistically significant differences in the recurrence rate among three groups(P <0.05). Conclusions Both deoxygestrel estradiol and levonorgestrel sustained-release system can effectively inhibit the recurrence of endometrial polyps. Levonorgestrel sustainedrelease system has the best effect, but it is not suitable for patients with fertility requirement.