宫腔镜切除子宫内膜息肉术后四种方法预防复发临床研究

Clinical study of four methods to prevent recurrence after hysteroscopic resection of endometrial polyps

目的对比宫内放置曼月乐、口服短效避孕药、孕激素及单纯TCRP术对子宫内膜息肉切除术(TCRP)术后复发的预防效果.方法选择2020年1月-2020年12月期间于佛山市南海区桂城医院接受治疗的子宫内膜息肉(EP)患者175例作为研究对象,术后根据不同治疗方法分为A组(曼月乐,n=48)、B组(短效避孕药,n=43)、C组(孕激素,n=44)及D组(对照组,n=40).分别评价其手术治疗效果,同时于术后1、6、12个月随访四组患者的子宫内膜厚度、月经量改善情况、血红蛋白水平及术后复发情况.结果①四组患者TCRP手术疗效无显著性差异(P>0.05).②术后1、6、12个月,四组患者子宫内膜厚度均低于术前;术后12个月,A组患者子宫内膜厚度显著低于B组、C组及对照组(P<0.05),B组、C组与对照组比较,差异不明显(P>0.05).③术后6、12个月,治疗组患者月经改善比例均高于对照组(P<0.05);组间比较,A组较B组、C组比例均高(P<0.05),B组与C组比较,差异无统计学意义(P>0.05).④术后12个月治疗组术后血红蛋白水平均明显高于对照组(P<0.05),三组间比较,无显著性差异(P>0.05).⑤术后12个月治疗组复发率均显著低于对照组(χ^(2)=4.351,P<0.01);治疗组间比较,差异不明显.结论TCRP术后联合曼月乐、口服短效避孕药及孕激素均能显著降低EP复发率、提高血红蛋白水平,但联合曼月乐更有助于抑制子宫内膜厚度,同时改善月经情况,具有推广价值.

Objective Comparison of the preventive efes of four kinds of endometrial polypectomy(TCRP)pnstoperative rcurrence.Methods 175 patients with endometrial polyps(EP)were selected as the research objec.According to different treatment methods,hey were divided into group A(manyuele,n=48)group B(short acting contraceptive.n=43).group C(progesterone.n=44)and group D(control group,n=40).The endometrial thickness.menstual volume,hemoglobin level and postoperative recurrence of the four groups were followed up.Results Al 1,6,and 12 months after operation,the endometrial thickness of the four groups of patients was lower than that before the operaion;12 months afer the operation,the endometrial thickness of group A was signifcanly lower than that of group B,group C and control group(P<0.05),there is no significant dfference between goup B.group C and the control group.At 6 and 12 months after the operaion,he menstrual improvement ratio of the treatment group was higher than that of the control group(P<0.05):compared between the groups,the ratio of group A was higher than that of group B and group ( P<0.05).Group B compared with group C the difference between the groups was not statistically significant(P>0.05).Twelve months after operation,the hemoglobin level in the trealment group was significanly higher than that in the control group(P<0.05).The recurrence rale in the trealment group was significantly higher than that in the control group 12 months after operation.Conclusion After TCRP combined with Mirena,oral short-acting contraceptives and progesterone can significantly reduce EP reeurrence rate and inerease hemoglobin levels,but combined with Mirena is more helpful in suppressing the thickness of the endometrium and improving menstruation at the same time.It has promotion value.