宫腔镜子宫内膜息肉电切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观察

Effect of Hysteroscopic Electroresection of Endometrial Polyps Combined with Levonorgestrel Intrauterine Birth Control System in the Treatment of Endometrial Polyps

目的:探究宫腔镜子宫内膜息肉电切术联合左炔诺孕酮宫内节育系统治疗子宫内膜息肉(endometrial polyps,EP)的效果,并分析对患者月经量、血清性激素等指标的影响。方法:从2020年4月—2021年6月时间段抽取在我院妇科治疗的EP患者62例,分为两组,各31例。对照组治疗通过宫腔镜息肉电切术,并在术后服用地屈孕酮,观察组同样以宫腔镜息肉电切术治疗,但术后置入左炔诺孕酮宫内节育系统。比较两组术后不同时间子宫内膜厚度、月经量、血清性激素指标水平、复发情况。结果:术后3个月、6个月观察组患者子宫内膜厚度小于对照组(P<0.05);术后2个月、4个月、6个月观察组患者月经量低于对照组(P<0.05);术后3个月观察组性激素FSH水平低于对照组,而观察组性激素LH水平高于对照组(P<0.05);术后6个月观察复发率为3.22%,低于对照组的19.35%(P<0.05)。结论:EP通过宫腔镜息肉电切术治疗,并在术后置入左炔诺孕酮宫内节育系统,可在极大程度上调控月经量,调节子宫内膜厚度,且可改善激素紊乱,平稳LH与FSH的激素水平,有效抑制再次复发。

Objective:To investigate the effect of hysteroscopic electroresection of endometrial polyps combined with levonorgestrel intrauterine contraception system in the treatment of endometrial polyps(EP),and to analyze the influence on menstrual volume,serum sex hormones and other indicators of patients.Methods:From April 2020 to June 2021,62 CASES of EP patients treated in our hospital were selected and divided into two groups,31 cases in each group.The control group was treated with hysteroscopic electroresection of polyps and dydrogestrel after surgery,while the observation group was also treated with hysteroscopic electroresection of polyps,but with levonorgestrel intrauterine birth control system after surgery.Endometrial thickness,menstrual volume,serum sex hormone levels and recurrence were compared between the two groups at different time after operation.Results:The endometrial thickness of observation group was less than that of control group at 3 and 6 months after operation(P<0.05).The menstrual volume in observation group was lower than that in control group at 2,4 and 6 months after surgery(P<0.05).Three months after surgery,the level of sex hormone FSH in observation group was lower than that in control group,while the level of sex hormone LH in observation group was higher than that in control group(P<0.05).6 months after operation,the recurrence rate was 3.22%lower than 19.35%in the control group(P<0.05).Conclusion:EP is treated by hysteroscopic polyp electrotomy and implanted with levonorgestrel intrauterine birth control system after operation,which can greatly regulate menstrual volume and endometrial thickness,improve hormone disorder,stabilize hormone levels of LH and FSH,and effectively inhibit recurrence.