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的临床研究

Clinical study on treatment of endometrial polyps by hysteroscopic electrotomy combined with levonorgestrel intrauterine sustained-release system

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的临床疗效。方法55例子宫内膜息肉患者,使用抽签分组方式分为对照组(25例)和研究组(30例)。对照组接受宫腔镜电切术治疗,研究组接受宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗。统计比较两组患者卵巢功能[促卵泡生成激素(FSH)、黄体生成激素(LH)、雌二醇(E2)]、月经失血量、6个月复发率和1年复发率及治疗前后子宫内膜厚度、血红蛋白水平。结果治疗后,研究组子宫内膜厚度(5.31±1.45)mm小于对照组的(7.44±1.44)mm,血红蛋白水平(100.66±4.11)g/L高于对照组的(94.56±4.33)g/L,差异有统计学意义(P<0.05)。对照组月经失血量为(44.78±3.66)ml,研究组月经失血量为(32.68±4.45)ml;研究组月经失血量少于对照组,差异有统计学意义(P<0.05)。两组FSH、LH、E2水平比较差异无统计学意义(P>0.05)。研究组6个月复发率及1年复发率均低于对照组,差异有统计学意义(P<0.05)。结论子宫内膜息肉患者采用宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗,能有效降低子宫内膜息肉复发率,减少月经量,对卵巢功能无影响,值得临床推广。

Objective To discuss the clinical efficacy of endometrial polyps treated by hysteroscopic electrotomy combined with levonorgestrel intrauterine sustained-release system.Methods A total of 55 endometrial polyps patients were divided into control group(25 cases)and research group(30 cases)by lottery method.The control group was treated by hysteroscopic electric resection,and the research group was treated by hysteroscopic electric resection combined with levonorgestrel intrauterine sustained release system.The ovarian function[follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)],menstrual volume,6-month recurrence rate,1-year recurrence rate,endometrial thickness and hemoglobin level before and after treatment were compared between the two groups.Results After treatment,the endometrial thickness(5.31±1.45)mm of research group was less than that of the control group(7.44±1.44)mm,and hemoglobin level(100.66±4.11)g/L was higher than that of the control group(94.56±4.33)g/L,and the difference was statistically significant(P<0.05).The menstrual volume of the control group was(44.78±3.66)ml,which was(32.68±4.45)ml of the research group.The menstrual blood loss of the research group was less that that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in levels of FSH,LH,E2 between the two groups(P>0.05).The 6-month recurrence rate and 1-year recurrence rate of the research group were lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Hysteroscopic electrotomy combined with levonorgestrel intrauterine sustained-release system can effectively reduce the recurrence rate of endometrial polyps,reduce menstrual volume,and have no effect on ovarian function.It is worthy of clinical promotion.