地屈孕酮片联合宫腔镜手术治疗子宫内膜息肉患者的效果

Effects of Dydrogesterone tablets combined with hysteroscopic surgery in treatment of patients with endometrial polyps

目的:探讨地屈孕酮片联合宫腔镜手术治疗子宫内膜息肉(EP)患者的效果。方法:选取2017年8月至2021年5月该院收治的88例EP患者进行前瞻性研究,按照随机数字表法分为观察组和对照组各44例。对照组予以宫腔镜手术治疗,观察组在对照组的基础上联用地屈孕酮片治疗,持续治疗3个月。比较两组临床疗效,治疗前后月经量、子宫内膜厚度、血管内皮生长因子(VEGF)水平、雌孕激素受体表达情况,以及并发症发生率、复发率。结果:观察组治疗总有效率为95.45%(42/44),高于对照组的81.82%(36/44),差异有统计学意义(P<0.05);治疗后,观察组孕激素受体表达评分高于对照组,月经量少于对照组,子宫内膜厚度小于对照组,VEGF水平、雌激素受体表达评分均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率、复发率分别为4.55%(2/44)、4.76%(2/42),低于对照组的25.00%(11/44)、25.00%(9/36),差异均有统计学意义(P<0.05)。结论:地屈孕酮联合宫腔镜手术治疗EP患者可提高治疗总有效率,纠正体内雌孕激素受体异常表达状态,促进月经恢复正常,降低术后子宫内膜厚度、VEGF水平、并发症发生率及复发率。

Objective: To explore effects of Dydrogesterone tablets combined with hysteroscopic surgery in treatment of patients with endometrial polyps(EP). Methods: A prospective study was conducted on 88 EP patients admitted to this hospital from August 2017 to May 2021.According to the random number table method, they were divided into observation group and control group, 44 cases in each. The control group was treated with hysteroscopic surgery, while the observation group was treated with Dydrogesterone tablets on the basis of that of the control group. The treatment lasted for 3 months continuously. The clinical efficacy, the menstrual blood volume, the endometrial thickness, the vascular endothelial growth factor(VEGF) level, the estrogen and progesterone receptor expressions, the complication rate and the recurrence rate were compared between the two groups before and after the treatment. Results: The total effective rate of the observation group was 95.45%(42/44), which was higher than 81.82%(36/44) of the control group, and the difference was statistically significant(P<0.05). After the treatment, the progesterone receptor expression score in the observation group was higher than that in the control group;the menstrual blood volume was less than that in the control group;the endometrial thickness was smaller than that in the control group;the VEGF level and estrogen receptor expression score were lower than those in the control group;and the differences were statistically significant(P<0.05). Further, the complication rate and the recurrence rate of the observation group were 4.55%(2/44) and 4.76%(2/42), respectively, which were lower than 25.00%(11/44) and 25.00%(9/36) of the control group, and the differences were statistically significant(P<0.05). Conclusions: Dydrogesterone combined with hysteroscopic surgery in the treatment of the EP patients can improve the total effective rate of treatment, correct the abnormal expression of estrogen and progesterone receptors, promote the return of menstruation to normal, and reduce the postoperative endometrial thickness, the VEGF level and the complication rate and recurrence rate.