宫腔镜切除术联合LNG-IUS治疗子宫内膜息肉的临床作用研究

Clinical Effect of Hysteroscopic Resection Combined with LNG-IUS in the Treatment of Endometrial Polyps

目的:探讨宫腔镜息肉切除术联合LNG-IUS治疗EP的临床作用机制。方法:选取我院妇产科在2019年12月至2020年12月收治的60例EP患者作为研究对象,根据手术方式分为对照组与联合组,每组30例。对照组采用宫腔镜下息肉切除术治疗,联合组以对照组为基础,联合LNG-IUS治疗。对比两组患者临床疗效,治疗后子宫内膜厚度、复发率、内分泌激素(ER、PR)以及炎症相关因子(VEGF、TGF-β1、TNF-α、CRP、IL-6)变化情况。结果:术后,联合组总有效率优于对照组(P<0.05);术前,两组患者子宫内膜厚度对比无差异(P>0.05)。与术前相比,术后两组患者子宫内膜厚度减小。联合组术后各阶段子宫内膜厚度均较对照组小(P<0.05);术前,两组患者各项指标水平变化无明显差异(P>0.05)。术后,联合组VEGF、TGF-β1、TNF-α、CRP、IL-6、ER、PGR水平均优于对照组(P<0.05);术后12个月内,联合组总复发率为6.66%,对照组总复发率为33.33%,联合组优于对照组(P<0.05)。结论:宫腔镜电切术联用LNG-IUS其机制可能与下调ER、PR、VEGF、TGF-β1、TNF-α、CRP、IL-6的表达水平有关,提高子宫内膜息肉治疗效果,降低复发率,为EP的诊疗及相关机制研究提供理论依据。

Objective:To investigate the clinical mechanism of hysteroscopic polypectomy combined with LNG-IUS in the treatment of EP.Methods:A total of 60 EP patients admitted to the Department of Obstetrics and Gynecology of our hospital from December 2019 to December 2020 were selected as the research objects,and divided into matched group and joint group according to the manipulation method,with 30 cases in each group.The Matched group was treated with hysteroscopic polypectomy,and the joint group was treated with LNG-IUS on the basis of the matched group.The clinical efficacy,endometrial thickness,recurrence rate,endocrine hormones(ER,PR)and inflammation-related factors(VEGF,TGF-β1,TNF-α,CRP,IL-6)were compared between the two groups after treatment.Results:After operation,the total effective rate of the joint group was was better than the matched group(P<0.05).Before operation,there was no significant difference in endometrial thickness between the two groups.(P>0.05).After operation,the endometrial thickness of the two groups was significantly reduced compared with that before operation.The endometrial thickness in the joint group was smaller than that in the mtched group at each stage after operation(P<0.05);Before operation,there was no significant difference in the changes of various index levels between the two groups(P>0.05).After operation,the levels of VEGF,TGF-β1,TNF-α,CRP,IL-6,ER and PGR in the joint group were better than those in the matched group(P<0.05);Within 12 months after operation,the total recurrence rate of the joint group was 6.66%,the total recurrence rate in the Matched group was 33.33%,and the joint group was better than the matched group(P<0.05).Conclusion:The mechanism of hysteroscopic resection combined with LNG-IUS may be related to the down-regulation of the expression levels of ER,PR,VEGF,TGF-β1,TNF-α,CRP,and IL-6,and to improve the treatment effect of endometrial polyps.Reduce the recurrence rate and provide a theoretical basis for the diagnosis and treatment of EP and related moechanism,research.