宫腔镜直视下切除息肉联合左炔诺孕酮宫内节育系统治疗子宫内膜息肉的效果

Efficacy of transcercal resection of polyp combined with levonorgestrel intrauterine system in the treatment of endometrial polyps

目的:探究宫腔镜直视下切除息肉(transcercal resection of polyp,TCRP)联合左炔诺孕酮宫内节育系统治疗子宫内膜息肉(endometrial polyp,EP)患者的临床疗效。方法:回顾性选取2018年12月至2020年4月在池州市第二人民医院接受治疗的99例EP患者,根据治疗方法分为观察组(n=50)和对照组(n=49)。其中观察组患者采用TCRP联合左炔诺孕酮宫内节育系统治疗,对照组行TCRP联合黄体酮治疗,对比2组相关参数。结果:拔管时和拔管后5 min,2组患者的收缩压(systolic blood pressure,SBP)、心率(heart rate,HR)以及舒张压(diastolic blood pressure,DBP)差异均无统计学意义(均P>0.05)。术后3个月,观察组的月经失血图(Pictorial Blood Loss Assessment Chart,PBAC)评分低于对照组(P<0.05),2组血清雌二醇(estradiol,E2)水平差异无统计学意义(P>0.05)。18个月内观察组9例(18.00%)患者恢复正常月经出血模式,低于对照组的19例(38.78%),差异有统计学意义(P<0.05)。2组不良反应总发生率差异无统计学意义(P>0.05)。观察组术后24个月EP复发率低于对照组(P<0.05)。结论:TCRP联合左炔诺孕酮宫内节育系统可有效降低EP术后复发风险,但不适用于短期内有生育需求的患者。

Objective:To explore the clinical efficacy of transcercal resection of polyp(TCRP)combined with levonorgestrel intrauterine system in patients with endometrial polyps(EP).Methods:A total of 99 patients with EP who were treated in Second People’s Hospital of Chizhou City from December 2018 to April 2020 were retrospectively selected and divided into an observation group(n=50)and a control group(n=49)according to the treatment method.The observation group was treated with TCRP combined with levonorgestrel intrauterine system,while the control group was treated with TCRP combined with progesterone treatment.The relevant parameters of the 2 groups were compared.Results:There was no statistical significance in systolic blood pressure(SBP),heart rate(HR),and diastolic blood pressure(DBP)between 2 groups at the time of extubation and 5 min after extubation.Three months after the operation,the Pictorial Blood Loss Assessment Chart(PBAC)score in the observation group was lower than that in the control group(P<0.05),and there was no difference in the serum concentration of estradiol(E2)between the 2 groups(P>0.05).There were 9 patients(18.00%)who returned to normal menstrual bleeding pattern within 18 months in the observation group,lower than 19 patients(38.78%)in the control group(P<0.05).There was no difference in the total incidence of adverse reactions between the 2 groups(P>0.05),and the recurrence rate of EP 24 months after the surgery in the observation group was lower than that in the control group(P<0.05).Conclusion:TCRP combined with levonorgestrel intrauterine system can effectively reduce the risk of recurrence after EP,but it is not suitable for patients who need fertility in the short term.