宫腔镜下子宫内膜息肉切除术后口服避孕药与放置左炔诺孕酮宫内节育系统预防复发的效果分析

Analysis of the effect of oral contraceptives and levonorgestrel intrauterine system on preventing recurrence after trans-cervical resection of endometrial polyps

目的探讨宫腔镜下子宫内膜息肉切除术后口服避孕药与放置左炔诺孕酮宫内节育系统预防复发的效果。方法随机选取2017年4月至2018年4月民航总医院诊治的行TCRP治疗的子宫内膜息肉(EMP)患者240例作为研究对象。按平行对照法分为两组,各120例。对照组术后给予避孕药屈螺酮炔雌醇片口服,研究组术后宫腔放置左炔诺孕酮宫内节育系统。比较两组不同时段(术前,术后3个月、6个月、12个月)月经量、宫内膜厚度变化及随访结束时复发病例数。结果术后3个月、术后6个月、12个月时,研究组月经量少于对照组,差异具有统计学意义(均P=0.000);术后6个月、12个月时,研究组子宫内膜厚度低于对照组,差异具有统计学意义(均P=0.000);随访结束时,研究组复发率(0.00%)低于对照组的(5.00%),差异具有统计学意义(P=0.038)。结论宫腔镜下子宫内膜息肉切除术后宫腔放置左炔诺孕酮宫内节育系统预防复发的效果优于口服避孕药屈螺酮炔雌醇片,且能控制月经量、子宫内膜厚度,值得临床推广。

Objective To investigate the effect of oral contraceptives and levonorgestrel intrauterine system on preventing recurrence after trans-cervical resection of endometrial polyps(TCRP).Methods 240 patients with endometrial polyps(EMP)who were treated by TCRP from April 2017 to April 2018 were selected by random sampling.Parallel control method was adopted to divide the patients into two groups,120 cases each.The control group was given oral drospirone ethinylestradiol tablets after operation,and the study group was given levonorgestrel intrauterine system in the cervix after operation.The menstrual volume and endometrial thickness at different time points(preoperative and 3,6,12 months after operation)and the number of recurrences at the end of follow-up were compared between the two groups.Results At 3 months,6 months and 12 months after operation,the menstrual volume of the study group was less than that of the control group,with statistically significant differences(all P=0.000).At 6 months and 12 months after operation,the endometrial thickness of the study group was lower than that of the control group(both P=0.000).At the end of the follow-up,the recurrence rate in the study group(0.00%)was lower than that of the control group,with statistically significant difference(5.00%)(P=0.038).Conclusions The effect of levonorgestrel intrauterine system in preventing recurrence after TCRP is better than that of oral contraceptive drospirone ethinylestradiol tablet,and it can control menstrual volume and endometrial thickness,which is worthy of clinical promotion.