宫腔镜下子宫内膜息肉电切术后放置左炔诺孕酮宫内缓释系统的临床研究

Clinical Study of Levonorgestrel Intrauterine Sustained-release System after Hysteroscopic Endometrial Polypectomy

目的探讨子宫内膜息肉宫腔镜电切术后宫内放置左炔诺孕酮宫内缓释系统(曼月乐)的临床效果。方法方便选取2016年1月—2017年1月在蓬莱市人民医院住院治疗的79例子宫内膜息肉患者纳入研究,随机分为对照组和观察组,对照组40例,观察组39例。对照组采用常规子宫内膜息肉宫腔镜电切术,观察组在对照组的基础上加用曼月乐,于治疗后6个月、12个月随访观察两组患者子宫内膜厚度、血红蛋白水平、复发率。结果观察组子宫内膜厚度低于对照组[术后6个月:(0.47±0.15)cm vs(0.56±0.14)cm,(t=2.758);术后12个月:(0.39±0.11)cm vs(0.58±0.16)cm,(t=6.135)],差异有统计学意义(P<0.05),血红蛋白水平升高观察组优于对照组[术后6个月:(118.7±10.9)g/L vs(113.4±12.5)g/L,(t=2.007,P<0.05);术后12个月:(129.5±11.4)g/L vs(121.4±13.3)g/L,(t=2.903 P<0.05)],观察组子宫内膜息肉复发率于治疗后12个月明显低于对照组,差异有统计学意义(6例vs 1例)(χ^2=3.782,P<0.05)。结论子宫内膜息肉切除术后,给予宫腔内放置左炔诺孕酮宫内缓释系统能够有效降低子宫内膜厚度,明显减少月经量及术后子宫内膜息肉的复发,有重要临床意义。

Objective To explore the clinical effect of levonorgestrel intrauterine sustained-release system(Menyuele)placed in utero after hysteroscopic resection of endometrial polyps.Methods A total of 79 patients with endometrial polyps hospitalized in Penglai People's Hospital from January 2016 to January 2017 were selected and included in the study.They were randomly divided into a control group and an observation group,with 40 cases in the control group and 39 cases in the observation group.The control group received conventional endometrial polyp hysteroscopy,and the observation group added Manyule on the basis of the control group.The endometrial thickness,hemoglobin level,and recurrence rate of the two groups were observed at 6 and 12 months after treatment.Results The endometrial thickness of the observation group was lower than that of the control group[6 months after operation:(0.47±0.15)cm vs(0.56±0.14)cm(t=2.758);12 months after operation:(0.39±0.11)cm vs(0.58±0.16)cm(t=6.135)].The difference was statistically significant(P<0.05).The increased hemoglobin level in the observation group was superior to the control group[6 months after surgery:(118.7±10.9)g/L vs(113.4±12.5)g/L(t=2.007,P<0.05);12 months after surgery:(129.5±11.4)g/L vs(121.4±13.3)g/L(t=2.903,P<0.05)].The recurrence rate of endometrial polyps in the observation group was significantly lower than that in the control group 12 months after treatment,the difference was statistically significant(6 cases vs 1 case)(χ^2=3.782,P<0.05).Conclusion After the endometrial polyps are removed,the intrauterine sustained-release system placed in the uterine cavity can effectively reduce the thickness of the endometrium,significantly reduce the menstrual volume and the recurrence of postoperative endometrial polyps significance.