宫腔镜手术联合孕激素对多发性子宫内膜息肉术后复发的影响

The Effect of Hysteroscopic Surgery Combined with Progesterone on Recurrence of Multiple Endometrial Polyps after Surgery

目的分析宫腔镜手术联合孕激素对多发性子宫内膜息肉术后复发的影响,探究宫腔镜手术联合应用孕激素的价值,为临床中多发性子宫内膜息肉治疗提供参考依据。方法方便选取2018年3月—2021年3月期间于该院行宫腔镜手术治疗的多发性子宫内膜息肉患者,共220例,以随机信封法分为对照组(n=110)、研究组(n=110)。对照组单独采用宫腔镜手术治疗,研究组于对照组基础上应用孕激素(地屈孕酮片),持续随访12个月,观察两组患者术后复发率情况、子宫内膜厚度、血红蛋白水平、并发症发生率。结果研究组患者术后复发率为1.82%,低于对照组的13.64%,差异有统计学意义(χ^(2)=10.774,P<0.05);随访12个月,研究组患者子宫内膜厚度、血红蛋白水平分别为(0.71±0.10)cm、(119.62±7.04)g/L,与对照组的(0.98±0.12)cm、(94.27±6.98)g/L对比,差异有统计学意义(t=18.129、26.819,P<0.001);研究组患者的并发症发生率为4.55%,对照组患者的术后并发症发生率分别为3.64%,两组并发症发生率差异无统计学意义(χ^(2)=0.000,P>0.05)。结论宫腔镜手术治疗多发性子宫内膜息肉后,予以患者孕激素口服治疗,能够降低子宫内膜厚度、提升血红蛋白水平,从而有效预防术后复发,而且不增加并发症风险,具有良好应用价值,建议于临床中推广使用。

Objective Analyze the effect of hysteroscopic surgery combined with progesterone on the recurrence of multiple endometrial polyps after surgery,explore the value of hysteroscopic surgery combined with progesterone,and provide a reference for the treatment of multiple endometrial polyps in the clinic.Methods A total of 220 patients with multiple endometrial polyps who underwent hysteroscopic surgery in the hospital from March 2018 to March 2021 were conveniently selected.The random envelope method was divided into control group(n=110)and study group(n=110).The control group was treated with hysteroscopic surgery alone,and the study group was treated with progesterone on the basis of the control group(dydrogesterone tablets).Continued follow-up for 12 months.Observed the postoperative recurrence rate,endometrial thickness,hemoglobin level,and complication rate of the two groups of patients.Results The postoperative recurrence rate was 1.82%in the study group,lower than 13.64%in the control group,and the difference was statistically significant(χ^(2)=10.774,P<0.05).After 12 months of follow-up,endometrial thickness and hemoglobin levels in the study group were(0.71±0.10)cm and(119.62±7.04)g/L,respectively,compared with the control group(0.98±0.12)cm,(94.27±6.98)g/L,the difference was statistically significant(t=18.129,26.819,P<0.001).The incidence of postoperative complications was 4.55%in the study group and 3.64%in the control group,respectively,with no statistically significant difference between the two groups(χ^(2)=0.000,P>0.05).Conclusion After hysteroscopic surgery for multiple endometrial polyps,oral progesterone treatment can reduce the thickness of the endometrium and increase the level of hemoglobin.Thereby effectively preventing postoperative recurrence without increasing the risk of complications.It has good application value,and it is recommended to be promoted and used in clinical practice.