宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗子宫内膜息肉疗效及对性激素和脂代谢影响

Clinical efficacy of hysteroscopic electrotomy combined with levonorgestrel intrauterine sustained release system for treating the women with endometrial polyps and its effect on their sex hormone and lipid metabolism levels

目的:探究宫腔镜电切术联合左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫内膜息肉的临床疗效及对患者性激素和脂代谢水平影响。方法:选取2018年1月—2021年1月本院收治的子宫内膜息肉患者50例,随机数字法分为观察组(n=25)和对照组(n=25),两组均行宫腔镜电切术,观察组联合左炔诺孕酮宫内缓释系统治疗。术后随访两年。分别于术前、术后6、12个月检测两组血清卵泡刺激素(FSH)和雌二醇(E_(2)),及总胆固醇(CHO)、甘油三脂(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)、载脂蛋白A1(LAA1)以及载脂蛋白B(LAB),统计并发症及感染和复发情况。结果:观察组治疗疗效(96.0%)高于对照组(76.0%)(P<0.05);治疗后两组FSH和LH水平均下降且观察组低于对照组,观察组CHO、TG、LDL-C、LAA1、LAB水平均低于对照组,而HDL-C高于对照组(均P<0.05);观察组治疗后并发症发生率(4.0%)以及复发率(0)均低于对照组(20.0%、16.0%)(P<0.05);观察组术后月经周期和经期疼痛评分较术前无明显差异(P>0.05),但经期出血量较术前增多(P<0.05)。结论:宫腔镜电切术联合左炔诺孕酮宫内缓释系统对子宫内膜息肉患者的治疗疗效确切,且能够改善患者的性激素和脂代谢水平。

Objective:To investigate the clinical efficacy of hysteroscopic electrotomy combined with levonorgestrel intrauterine prolonged release system(LNG-IUS)for treating the women with endometrial polyps,and to study its effect on the sex hormone and lipid metabolism levels of the women.Methods:From January 2018 to January 2021,50 women with endometrial polyp were given hysteroscopic surgery for treating endometrial polyps.According to the method of random number,these women were divided into observation group and control group(25 cases in each group).The women in the observation group were also inserted LNG-IUS.All these women were followed up for two years after surgery.The levels of follicular estrogen(FSH)and estradiol(E_(2)),the total cholesterol(CHO),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),apolipoprotein A1(LAA1),and apolipoprotein B(LAB)of the women in the two groups were measured before surgery,6 months and 12 months after surgery.The incidences of complications,infection,and the recurrence of endometrial polyps of the women in the two groups were analyzed.Results:The curative effect(96.0%)of the women in the observation group was significant higher than that(76.0%)of the women in the control group(P<0.05).The FSH and LH levels of the women in the two groups had decreased significantly after treatment,and which of the women in the observation group was significant lower than that of the women in the control group.The levels of CHO,TG,LDL-C,LAA1,and LAB of the women in the observation group were significant lower than those of the women in the control group,but the HDL-C level of the women in the observation group was significant higher(all P<0.05).The rates of complications(4.0%)and the recurrence(0%)of the women in the observation group were significant lower than those(20.0%and 16.0%)of the women in the control group(P<0.05).The preoperative menstrual cycle duration and menstrual pain scores of the women in the observation group had no significant different than those before operation(P>0.05),but the preoperative menstrual blood loss of the women in the observation group had increased significantly(P<0.05).Conclusion:Hysteroscopic electrotomy combined with LNG-IUS for treating the women with endometrial polyps has exact efficacy,which can improve their levels of sex hormone and lipid metabolism.