宫腔镜电切术联合LNG-IUS治疗对子宫内膜息肉患者 并发症和复发率的影响

Effect of hysteroscopic electrotomy combined with LNG-IUS on complications and recurrence rate of endometrial polyps

目的 探讨宫腔镜电切术(HES)联合左炔诺孕酮宫内节育系统(LNG-IUS)治疗对子宫内膜息肉(EP)患者并发症和复发率的影响。方法 选取行HES治疗的56例EP患者,按照随机数字表法分为对照组与试验组,各28例。对照组采用单纯宫腔镜电切术治疗,试验组采用宫腔镜电切术联合LNG-IUS治疗。对比两组的月经恢复情况、性激素水平、子宫内膜厚度、并发症发生情况及复发率。结果 手术前,两组月经失血图(PBAC)评分对比,差异无统计学意义(P>0.05);手术后6、12个月,两组PBAC评分均低于手术前,且试验组明显低于对照组,差异有统计学意义(P<0.05)。手术前,两组卵泡刺激素(FSH)和促黄体生成素(LH)水平对比,差异无统计学意义(P>0.05);手术后12个月,两组FSH、LH水平均低于手术前,且试验组明显低于对照组,差异有统计学意义(P<0.05)。手术前,两组子宫内膜厚度对比,差异无统计学意义(P>0.05);手术后6、12个月,两组子宫内膜厚度明显薄于手术前,且试验组薄于对照组,差异有统计学意义(P<0.05)。试验组、对照组的并发症发生率分别为17.85%、10.71%,对比差异无统计学意义(P>0.05);试验组复发率0%低于对照组的21.43%,差异有统计学意义(P<0.05)。结论 HES联合LNG-IUS治疗EP,可有效调节患者的性激素水平,促进月经恢复,降低子宫内膜厚度,并降低疾病复发率,但在降低术后并发症的效果不明显。

Objective To investigate the effect of HES combined with levonorgestrel intrauterine birth control system(LNGIUS) on complications and recurrence rates in patients with endometrial polyps(EP). Methods 56 patients with EP who received HES treatment were randomly divided into control group and experimental group, with 28 patients in each group. The control group was treated with hysteroscopic electrotomy alone, and the experimental group was treated with hysteroscopic electrotomy combined with LNG-IUS. Menstrual recovery, sex hormone levels, endometrial thickness, complications and recurrence rate were compared between the two groups. Results Before operation, there was no significant difference in PBAC score between the two groups(P>0.05). At 6 and 12 months after surgery, PBAC scores in both groups were lower than before surgery, and the test group was significantly lower than the control group, with statistical significance(P<0.05). Before operation, there was no significant difference in the levels of follicle stimulating hormone(FSH) and luteinizing hormone(LH) between the two groups(P>0.05). At 12 months after operation, the levels of FSH and LH in 2 groups were lower than before operation, and the experimental group was significantly lower than the control group, with statistical significance(P<0.05). Before operation, there was no significant difference in endometrial thickness between the two groups(P>0.05). At 6 and 12 months after surgery, endometrial thickness was significantly thinner in the two groups than before surgery, and the experimental group was thinner than the control group, the difference was statistically significant(P<0.05). The incidence of complications in experimental group and control group were 17.85% and 10.71%,respectively, with no statistical significance(P>0.05). The recurrence rate of experimental group was 0% lower than that of control group(21.43%), and the difference was statistically significant(P<0.05). Conclusion Hes combined with LNG-IUS in the treatment of EP can effectively regulate the level of sex hormones, promote menstrual recovery, reduce endometrial thickness, and reduce the recurrence rate of the disease, but it has no obvious effect in reducing postoperative complications.