曼月乐预防宫腔镜子宫内膜息肉电切术后复发的临床疗效

Clinical Efficacy of Mirena in Preventing Recurrence of TCRP

目的观察曼月乐(LNG-IUS)预防宫腔镜下子宫内膜息肉电切术后复发的疗效,为寻找有效、合理预防子宫内膜息肉电切术后复发提供指导。方法对共100例确诊为子宫内膜息肉未接受任何治疗或曾接受治疗无效或复发的患者,均行宫腔镜下子宫内膜息肉电切(TCRP),根据个人意愿随机分为三组,A组35例,宫腔镜下子宫内膜息肉电切术中即时放置曼月乐,放置后1、3、6、12个月随访子宫内膜息肉复发、月经恢复情况;B组40例,宫腔镜下子宫内膜息肉电切术后后半周期加服地屈孕酮3个疗程,术后1、3、6、12个月随访子宫内膜息肉复发、月经恢复情况;C组25例,宫腔镜下子宫内膜息肉电切术后不给予任何治疗,术后1、3、6、12个月随访子宫内膜息肉复发、月经恢复情况。结果三组患者经宫腔镜下子宫内膜息肉电切后与术前相比,月经均恢复正常,差异均有统计学意义(P<0.05),但术后1年A组EP复发1例(2.8%),B组EP复发3例(7.5%);C组EP复发4例(16%),三组比较差异均有统计学意义(P<0.05)。结论 TCRP可以有效切除子宫内膜息肉,从而改善月经,TCRP联合曼月乐及地屈孕酮治疗EP可以预防子宫内膜息肉术后复发,但曼月乐可以明显减少月经量,对增生过长的子宫内膜有抑制作用,其作用更持久、安全,是预防子宫内膜息肉电切术后复发的有效方法。

Objective To explore the clinical valus of the LNG-IUS levonorgestrel releasing intrauterine system prevention hysteroscopic endometrialresection of polyp recurrence, in order to effective and reasonable prevention of endometrial polyps(EP) recurrence after transurethral provide guidance. Methods A total of 100 patients diagnosed with endometrial polyps did not receive any treatment or had received treatment fails or relapse in patients underwent hysteroscopic endometrial polyps TCRP, according to the wishes of the individual randomly divided into three groups, a group of 35 cases of hysteroscopic resection of endometrial polyps for immediate placement of Mirena, after placing 1,3,6,12-month follow-up observation of endometrial polyp recurrence, menstruation recovery;group B 40 cases of hysteroscopic resection of endometrial polyps after serving half cycles plus dydrogesterone 3 courses, after1,3,6,12 months follow-up observation of endometrial polyp recurrence, menstruation recovery;group C 25 cases of hysteroscopic resection of endometrial polyps without giving any treatment, after 1,3,6,12-month follow-up observation of endometrial polyp recurrence, menstruation recovery. Results The three groups of patients with endometrial polyp compared with preoperative cut after hysteroscopic, menstruation returned to normal, the differences were statistically significant(P<0.05), but after one year A group EP recurrence in 1 case(2.8%) in group B EP 3 cases of recurrence(7.5%);group C EP recurrence in 4 cases(16%), the three groups were significantly different(P< 0.05). Conclusion TCRP effective removal of endometrial polyps, thereby improving menstruation, but TCRP joint Mirena EP and dydrogesterone treatment can prevent the recurrence of endometrial polyps, and Mirena can significantly reduce menstrual flow, hypertrophic long endometrial inhibit Mirena more lasting effect, it is an effective way to prevent endometrial polyp recurrence after transurethral resection.