宫腔镜电切术后放置左炔诺孕酮宫内节育系统预防子宫内膜息肉复发的临床效果

Clinical effect of levonorgestrel intrauterine system after hysteroscopic resection on preventing recurrence of endometrial polyps

目的探讨宫腔镜电切术后放置左炔诺孕酮宫内节育系统预防子宫内膜息肉复发的临床效果。方法选取漳州市医院2018年3月—2019年2月收治的子宫内膜息肉患者90例,按照随机数字表法分为对照组44例和观察组46例。2组均接受宫腔镜电切术治疗,对照组在术后不使用任何药物,观察组在术后放置左炔诺孕酮宫内节育系统。比较2组治疗前,治疗后6、12个月血红蛋白水平;治疗后3、6、12个月月经异常情况;治疗前,治疗后6、12个月月经量评分(PBAC)、子宫内膜厚度;治疗前、治疗后12个月雌二醇(E_(2))、黄体生成激素(LH)、卵泡生成激素(FSH);观察2组不良反应发生情况、复发情况。结果治疗前2组血红蛋白水平比较,差异无统计学意义(P>0.05);治疗后6、12个月观察组血红蛋白水平高于对照组(P<0.05)。治疗后3个月2组月经异常率比较,差异无统计学意义(P>0.05);治疗后6、12个月观察组月经异常率低于对照组(P<0.05)。治疗前2组PBAC评分比较,差异无统计学意义(P>0.05);治疗后6、12个月观察组PBAC评分低于对照组(P<0.05)。治疗前2组子宫内膜厚度比较,差异无统计学意义(P>0.05);治疗后6、12个月观察组子宫内膜厚度小于对照组(P<0.05)。2组治疗前、治疗后12个月E_(2)、LH、FSH比较,差异无统计学意义(P>0.05)。2组不良反应发生率,差异无统计学意义(P>0.05)。观察组治疗后3、6、12个月复发率低于对照组(P<0.05)。结论宫腔镜电切术后放置左炔诺孕酮宫内节育系统预防子宫内膜息肉复发的临床效果良好,能够改善患者血红蛋白水平和子宫内膜厚度,调节性激素水平,降低月经异常率和复发率,且安全性较高。

Objective To investigate the clinical effect of levonorgestrel(levonorgestrel)intrauterine device(IUD) on preventing recurrence of endometrial polyps after hysteroscopic resection.Methods A total of 90 cases of patients with endometrial polyps were selected from March 2018 to February 2019 in Zhangzhou Hospital,which were divided into control group(44 cases)and observation group(46 cases)according to random number table.The control group did not use any drugs after operation,and the observation group placed levonorgestrel intrauterine system after operation.The hemoglobin levels before treatment and at 6 and 12 months after treatment were compared between the two groups;the menstrual abnormalities at 3,6 and 12 months after treatment were compared between the two groups;the menstrual volume score(PBAC)and endometrial thickness before treatment and at 6 and 12 months after treatment were compared between the two groups;the estradiol(E_(2)),luteinizing hormone(LH)and follicle stimulating hormone(FSH)before treatment and at 12 months after treatment were compared between the two groups;the incidence of adverse reactions and recurrence of the two groups were observed.Results Before treatment,there was no significant difference in hemoglobin level between the two groups(P>0.05);after 6 and 12 months of treatment,the hemoglobin level of the observation group was higher than that of the control group(P<0.05).There was no significant difference in the rate of abnormal menstruation between the two groups 3 months after treatment(P>0.05);the rate of abnormal menstruation in the observation group was lower than that in the control group 6 and 12 months after treatment(P<0.05).There was no significant difference in PBAC score between the two groups before treatment(P>0.05);the PBAC score of the observation group was lower than that of the control group at 6 and 12 months after treatment(P<0.05).There was no significant difference in endometrial thickness between the two groups before treatment(P>0.05);the endometrial thickness of the observation group was less than that of the control group 6 and 12 months after treatment(P<0.05).There was no significant difference in E_(2),LH and FSH between the two groups before and 12 months after treatment(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The recurrence rate of the observation group at 3,6 and 12 months after treatment was lower than that of the control group(P<0.05).Conclusion The clinical effect of levonorgestrel intrauterine system in preventing recurrence of endometrial polyps after hysteroscopic resection is good.It can improve the hemoglobin level and endometrial thickness,regulate the sex hormone level,reduce the abnormal rate and recurrence rate of menstruation,and with high safety.