醋酸戈舍瑞林缓释植入剂与屈螺酮炔雌醇片(Ⅱ)辅助子宫内膜息肉电切除术治疗子宫内膜息肉的疗效及预后比较

Comparison of Efficacy and Prognosis of Goserelin Acetate Sustained-Release Implants and Drospirenone Ethinylestradiol Tablets(Ⅱ)Assisted Endometrial Polyp Resection in the Treatment of Endometrial Polyps

目的:比较戈舍瑞林缓释植入剂与屈螺酮炔雌醇片(Ⅱ)辅助子宫内膜息肉电切除术治疗子宫内膜息肉的疗效及预后。方法:回顾性分析2017年6月至2018年5月鄂东医疗集团黄石市妇幼保健院收治的95例子宫内膜息肉患者的临床资料,按照治疗方法的不同,将入选者分为对照组[屈螺酮炔雌醇片(Ⅱ)辅助子宫内膜息肉电切除术治疗,47例]和观察组(戈舍瑞林缓释植入剂辅助子宫内膜息肉电切除术治疗,48例)。比较两组患者的临床疗效、子宫内膜息肉复发情况、子宫内膜厚度、月经量、性激素[卵泡刺激素(FSH)、雌二醇(E2)及黄体生成素(LH)]水平及安全性的差异。结果:观察组患者的总有效率为89.58%(43/48),较对照组的80.85%(38/47)略高;随访6个月,观察组患者子宫内膜息肉复发率为6.25%(3/48),较对照组的17.02%(8/47)略低,但上述差异均无统计学意义(P>0.05)。治疗3、6个月后,两组患者子宫内膜厚度、月经量和FSH、E2及LH水平均有所降低,且观察组患者较对照组明显降低,差异均有统计学意义(P<0.05)。治疗期间,观察组患者的不良反应发生率为18.75%(9/48),较对照组的38.30%(18/47)明显更低,差异有统计学意义(P<0.05)。结论:对行子宫内膜息肉电切除术的患者采用戈舍瑞林缓释植入剂辅助治疗,比屈螺酮炔雌醇片(Ⅱ)辅助治疗的效果更好,可明显改善患者的临床症状,调节性激素水平,且安全性较高,有利于改善患者预后。

OBJECTIVE:To compare the efficacy and prognosis of goserelin acetate sustained-release implants and drospirenone ethinylestradiol tablets(Ⅱ)assisted endometrial polyp resection in the treatment of endometrial polyps.METHODS:Retrospective analysis was conducted on 95 patients with endometrial polyps admitted into Huangshi Maternal and Child Healthcare Hospital of Hubei Edong Medical Group from Jun.2017 to May 2018.According to different treatment methods,all patients were divided into the control group(drospirenone ethinylestradiol tablets(Ⅱ)assisted endometrial polyp resection treatment,n=47)and the observation group(goserelin acetate sustained-release implants and drospirenone ethinylestradiol tablets(Ⅱ)assisted endometrial polyp resection treatment,n=48).The clinical efficacy,recurrence of endometrial polyp,endometrial thickness,menstruation,sex hormone levels[follicle stimulating hormone(FSH),estradiol(E2)and luteinizing hormone(LH)]and safety were compared between two groups.RESULTS:The total effective rate was 89.58%(43/48)in the observation group,slightly higher than 80.85%(38/47)in the control group;the recurrence rate of endometrial polyp at 6-month follow-up in the observation group was 6.25%(3/48),slightly lower than that in the control group 17.02%(8/47),difference was not statistically significant(P>0.05).After 3 and 6 months of treatment,endometrial thickness,menstruation,FSH,E2 and LH levels of both groups decreased significantly,and the observation group was significantly lower than the control group,with statistically significant differences(P<0.05).During the treatment process,the incidence of adverse drug reactions in the observation group was 18.75%(9/48),significantly lower than that in the control group 38.30%(18/47),and the difference was statistically significant(P<0.05).CONCLUSIONS:Goserelin acetate sustained-release implants was more effective than drospirenone ethinylestradiol tablets(Ⅱ)in the adjuvant treatment of patients with endometrial polyps undergoing electrosurgical resection,which can obviously improve the clinical symptoms of patients,regulate the levels of sex hormones with higher safety,and is beneficial to improve the prognosis of patients.