左炔诺孕酮宫内缓释系统与屈螺酮炔雌醇片治疗宫腔镜子宫内膜息肉切除术后患者的效果比较

Comparison of effects of Levonorgestrel-releasing intrauterine system and Drospirenone and Ethinylestradiol tablets in treatment of patients after hysteroscopic endometrial polypectomy

目的:比较左炔诺孕酮宫内缓释系统与屈螺酮炔雌醇片治疗宫腔镜子宫内膜息肉(EP)切除术后患者的效果。方法:选取92例行宫腔镜EP切除术后患者为研究对象,按照随机数字表法分为观察组与对照组各46例。对照组行宫腔镜EP切除术后给予屈螺酮炔雌醇片口服治疗,观察组行宫腔镜EP切除术后给予宫腔内放置左炔诺孕酮宫内缓释系统治疗,比较两组EP复发率、手术前后子宫内膜厚度、月经失血图(PBAC)评分和血红蛋白(Hb)水平。结果:术后12个月,观察组复发率为6.52%,明显低于对照组的21.74%,差异有统计学意义(P<0.05);术后3、6、12个月,两组子宫内膜厚度均小于术前,且观察组小于对照组,PBAC评分均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);术后3、6、12个月,两组Hb水平均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:宫腔内放置左炔诺孕酮宫内缓释系统治疗宫腔镜子宫内膜息肉切除术后患者可降低术后复发率和PBAC评分,减小子宫内膜厚度,以及提高Hb水平,效果优于口服屈螺酮炔雌醇片。

Objective:To compare effects of Levonorgestrel-releasing intrauterine system and Drospirenone and Ethinylestradiol tablets in treatment of patients with endometrial polyps(EP).after hysteroscopic endometrial polypectomy Methods:92 patients who underwent hysteroscopic EP resection in our hospital were selected as the research objects,and were divided into observation group and control group according to the random number table method,46 cases in each group.The control group was given Drospirenone and Ethinylestradiol tablets orally after the surgery,while the observation group used the Levonorgestrel-releasing intrauterine system.The EP recurrence rate,the endometrial thickness,the pictorial blood loss assessment chart(PBAC)score and the hemoglobin(Hb)level were compared between the two groups.Results:12 months after the surgery,the recurrence rate of the observation group was 6.52%,which was significantly lower than the control group of 21.74%,and the difference was statistically significant(P<0.05).3,6,and 12 months after the surgery,the endometrial thickness of the two groups were less than those before the surgery;those of the observation group was less than those of the control group;and the PBAC score of the two groups were lower than those before the surgery;those of the observation group was lower than those of the control group;and the differences were statistically significant(P<0.05).3,6,and 12 months after the surgery,the Hb levels in the two groups were higher than those before the surgery;that of the observation group was higher than that of the control group;and the difference was statistically significant(P<0.05).Conclusions:Intrauterine placement of Levonorgestrel-releasing intrauterine system in the treatment of the EP patients after hysteroscopic endometrial polypectomy can reduce the postoperative recurrence rate,the endometrial thickness and the PBAC score,and improve the Hb levels.Moreover,it is superior to oral administration Drospirenone and Ethinylestradiol tablets.