子宫内膜息肉切除术后宫内放置曼月乐与口服达英-35的临床效果比较

Comparison of the clinical effects between intrauterine placement of Mirena and oral administration of Diane-35 after transcervical resection of endometrial polyps

目的比较子宫内膜息肉切除术后宫内放置曼月乐与口服达英-35的临床效果。方法回顾性收集2019年7月至2020年7月梧州市红十字会医院收治的61例子宫内膜息肉患者的病历资料,均行宫腔镜电切术。根据患者术后治疗方式分为曼月乐组(宫内放置曼月乐,n=30)和达英-35组(口服达英-35,1片/次,1次/d,连续用药21 d,重复6个周期;n=31)。比较两组术后经期改善情况、子宫膜厚度、复发率以及不良反应发生率。结果曼月乐组治疗有效率高于达英-35组,但差异无统计学意义(96.67%vs 77.42%;χ^(2)=3.411,P=0.065)。在术前、术后3个月,曼月乐组与达英-35组的子宫内膜厚度相比,差异无统计学意义(P>0.05)。在术后6个月、术后12个月,曼月乐组的子宫内膜厚度低于达英-35组,差异有统计学意义(P<0.05)。在术后12个月的观察期内,达英-35组的总复发率高于曼月乐组,差异有统计学意义(25.81%vs 3.33%;χ^(2)=4.466,P=0.035)。曼月乐组术后不良反应发生率显著低于达英-35组(13.33%vs 38.71%;χ^(2)=5.074,P=0.024)。结论宫内放置曼月乐比口服达英-35能更有效地降低子宫内膜息肉电切术后的复发率,且不良反应发生率更低。

Objective To compare the clinical effects between intrauterine placement of Mirena and oral administration of Diane-35 after transcervical resection of endometrial polyps.Methods The medical records of 61 patients with endometrial polyps admitted to Wuzhou Red Cross Hospital from July 2019 to July 2020 were retrospectively collected,and all the patients underwent hysteroscopic electric resection.The patients were divided into the Mirena group(intrauterine placement of Mirena,n=30)and the Diane-35 group(oral administration of Diane-35,one tablet each time,once a day,for 21 consecutive days,repeated for 6 cycles,n=31)according to their postoperative treatments.The improvement of menstrual period,thickness of uterine membrane,recurrence rate and incidence of adverse reactions were compared between the two groups after operation.Results The effective rate of the Mirena group was higher than that of the Diane-35 group,but the difference was not statistically significant(96.67%vs 77.42%;χ^(2)=3.411,P=0.065).There was no significant difference in endometrial thickness between the Mirena group and the Diane-35 group before operation and 3 months after operation(P>0.05).The endometrial thickness of the Mirena group was thinner than that of the Diane-35 group 6 months and 12 months after operation,and the differences were statistically significant(P<0.05).During the observation period of 12 months after operation,the total recurrence rate of the Diane-35 group was higher than that of the Mirena group,and the difference was statistically significant(25.81%vs 3.33%;χ^(2)=4.466,P=0.035).The incidence of postoperative adverse reactions in the Mirena group was significantly lower than that in the Diane-35 group(13.33%vs 38.71%;χ^(2)=5.074,P=0.024).Conclusion Compared with oral administration of Diane-35,intrauterine placement of Mirena can more effectively reduce the recurrence rate after endometrium electroresection of polyps,and has lower incidence of adverse reactions.