宫腔镜下子宫内膜息肉切除术联合左炔诺孕酮宫内节育系统治疗子宫内膜息肉的效果

Effect of hysteroscopic hysterectomy combined with levonorgestrel intrauterine sustained-release system on endometrial polyps

目的分析宫腔镜下子宫内膜息肉切除术联合左炔诺孕酮宫内节育系统(商品名:曼月乐)治疗子宫内膜息肉的临床疗效。方法106例子宫内膜息肉患者,采用随机数字表法分为对照组和研究组,每组53例。对照组采取宫腔镜下子宫内膜息肉切除术治疗,研究组采取宫腔镜下子宫内膜息肉切除术联合曼月乐治疗。比较两组患者手术前、术后3个月、术后6个月的月经量、子宫内膜厚度,术后1年内的息肉复发情况,治疗效果。结果手术前,两组患者的月经量、子宫内膜厚度对比,差异均无统计学意义(P>0.05);术后3、6个月,两组患者的月经量、子宫内膜厚度均优于本组手术前,且研究组显著优于对照组,差异具有统计学意义(P<0.05)。研究组患者术后1年内息肉复发率为5.66%,低于对照组的32.08%,差异有统计学意义(P<0.05)。研究组患者的总有效率为94.34%,高于对照组的67.92%,差异有统计学意义(P<0.05)。结论子宫内膜息肉患者行宫腔镜下子宫内膜息肉切除术是首选治疗方式,术后联合曼月乐可以有效改善月经量与子宫内膜厚度,降低术后息肉复发率。

Objective To analyze the clinical efficacy of hysteroscopic hysterectomy combined with levonorgestrel intrauterine sustained-release system(trade name:Mirena)on endometrial polyps.Methods A total of 106 patients with endometrial polyps were divided into control group and research group according to random numerical table,with 53 cases in each group.The control group was treated with hysteroscopic hysterectomy,and the research group was treated with hysteroscopic hysterectomy combined with levonorgestrel intrauterine sustained-release system.The menstrual volume and endometrial thickness before surgery,3 months after surgery,6 months after surgery,polyp recurrence within 1 year after surgery,and the treatment effect of the two groups were compared.Results Before surgery,there was no statistically significant difference in menstrual volume and endometrial thickness between the two groups(P>0.05).3 and 6 months after the surgery,the menstrual volume and endometrial thickness of the two groups were all better than those before surgery,and the research group was significantly better than the control group.The difference was statistically significant(P<0.05).The polyp recurrence within 1 year after surgery of the research group was 5.66%,which was lower than 32.08%of the control group,and the difference was statistically significant(P<0.05).The total effective rate of the research group was 94.34%,which was higher than 67.92%of the control group,and the difference was statistically significant(P<0.05).Conclusion Hysteroscopic hysterectomy is the first choice for the treatment of endometrial polyps.Postoperative levonorgestrel intrauterine sustained-release system can effectively improve menstrual volume and endometrial thickness,and reduce the recurrence rate of postoperative polyps.