LNG-IUS辅助宫腔电切术治疗子宫内膜息肉效果观察

Effect of LNG-IUS assisted hysterectomy in treatment of endometrial polyps

目的探讨宫腔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效果。方法选取2015年4月—2018年4月我院收治的子宫内膜息肉患者96例,按随机数字表法分为两组,各48例,对照组采用宫腔镜电切术,观察组在对照组基础上联合左炔诺孕酮宫内缓释系统治疗,比较两组子宫内膜厚度、血红蛋白水平、雌孕激素受体及表皮生长因子表达、术后12个月复发率。结果观察组术后子宫内膜厚度为(4.78±3.74)mm,低于对照组的(7.58±4.21)mm,观察组术后血红蛋白为(125.33±12.15)g/L,高于对照组的(107.48±10.23)g/L,差异有统计学意义(P<0.05);观察组术后表皮生长因子(EGF)、雌激素受体(ER)、孕激素受体(PR)表达分别为(1.41±0.35)%、(1.42±0.34)%、(1.04±0.29)%,均低于对照组的(1.99±0.43)%、(1.94±0.41)%、(1.53±0.31)%,差异有统计学意义(P<0.05);观察组复发率为4.16%,低于对照组的22.91%,差异有统计学意义(χ^2=7.207,P=0.007)。结论左炔诺孕酮宫内缓释系统与宫腔电切术联合治疗子宫内膜息肉疗效确切,可有效减低雌孕激素受体及表皮生长因子的表达,降低复发率,值得进一步推广。

Objective To investigate the clinical effect of hysterectomy combined with levonorgestrel intrauterine sustained release system(LNG-IUS)in the treatment of endometrial polyps.Methods From April 2015 to April 2018,96 patients with endometrial polyps were randomly divided into a control group and a trial group,with 48 cases in each group.The control group was treated with hysteroscopic electroresection,and the trial group was treated with LNG-IUS on the basis of the control group.The intimal thickness,hemoglobin level,expressions of estrogen and progesterone receptor and epidermis growth factor,and the 12-month postoperative recurrence rates were investigated and compared between the two groups.Results The average postoperative intimal thickness in the trial group was(4.78±3.74)mm,which was lower than that in the control group[(7.58±4.21)mm];the average hemoglobin in the trial group was(125.33±12.15)g/L,which was significantly higher than that in the control group[(107.48±10.23)g/L,P<0.05].The average postoperative EGF,ER,PR levels in the trial group were(1.41±0.35)%,(1.42±0.34)%,and(1.04±0.29)%,respectively,which were lower than those in the control group[(1.99±0.43)%,(1.94±0.41)%,and(1.53±0.31)%,respectively,P<0.05].The 12-month postoperative recurrence rate in the trial group was 4.16%,which was significantly lower than that in the control group(22.91%),and the difference was statistically significant(χ^2=7.207,P=0.007).Conclusion Hysterectomy combined with LNG-IUS is effective in the treatment of endometrial polyposis,which can effectively reduce the expressions of the estrogen and progesterone receptor and epidermis growth factor,and reduce the recurrence rate,therefore,it is worthy of further promotion.