左炔诺孕酮宫内释放系统联合黄体酮胶囊治疗宫腔镜下子宫内膜息肉切除术后患者的效果

Effects of Levonorgestrel Intrauterine Release System Combined with Progesterone Capsules in the Treatment of Patients after Hysteroscopic Transcervical Resection of Endometrial Polyps

目的:探讨左炔诺孕酮宫内释放系统联合黄体酮胶囊治疗宫腔镜下子宫内膜息肉切除术(TCRP)后患者的效果。方法:选择2020年7月—2022年3月扬州市妇幼保健院收治的88例TCRP后患者,按照随机数表法分为两组,各44例。对照组给予左炔诺孕酮宫内释放系统治疗,观察组在对照组基础上加用黄体酮胶囊治疗,比较两组临床疗效、不同时间点血红蛋白水平、子宫内膜容受性、子宫内膜组织表达水平及复发率。结果:观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗1个月经周期后、治疗结束后,两组血红蛋白水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗结束后,两组子宫内膜厚度、子宫体积小于治疗前,且观察组小于对照组,差异有统计学意义(P<0.05)。治疗结束后,观察组酪氨酸激酶生长因子受体(C-kit)、C-kit配体干细胞因子(SCF)、乙醛脱氢酶1(ALDH1)低于对照组,差异有统计学意义(P<0.05)。随访期间,观察组复发率为2.44%,低于对照组的5.88%,但两组间比较,差异无统计学意义(χ^(2)=0.028,P=0.868)。结论:左炔诺孕酮宫内释放系统联合黄体酮胶囊在TCRP后患者中具有良好疗效,不仅能够有效控制机体血红蛋白水平,改善临床症状,还能够有效调节子宫内膜组织表达水平,改善子宫内膜容受性,且不增加术后复发率。

Objective:To explore the effect of Levonorgestrel Intrauterine Release System combined with Progesterone Capsules in the treatment of patients after hysteroscopic transcervical resection of endometrial polyps(TCRP).Method:A total of 88 patients with TCRP treated in Yangzhou Maternal and Child Health Hospital from July 2020 to March 2022 were selected and divided into two groups according to random number table method,with 44 patients in each group.The control group was treated with Levonorgestrel Intrauterine Release System,and the observation group was treated with Progesterone Capsules on the basis of the control group.The clinical efficacy,hemoglobin level at different time points,endometrial receptivity,endometrial tissue expression level and recurrence rate were compared between the two groups.Result:The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment for 1 menstrual cycle and after treatment,hemoglobin level in the two groups was higher than those before treatment,and observation group were higher than those of control group,the differences were statistically significant(P<0.05).After treatment,endometrial thickness and uterine volume in the two groups were less than those before treatment,and the observation group were less than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the tyrosine kinase growth factor receptor(C-kit),C-kit ligand stem cell factor(SCF)and acetaldehyde dehydrogenase 1(ALDH1)in the two groups were lower than those before treatment,and the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).During the follow-up period,the recurrence rate in the observation group was 2.44%,which was lower than 5.88%in the control group,but there was no significant difference between the two groups(χ^(2)=0.028,P=0.868).Conclusion:Levonorgestrel Intrauterine Release System combined with Progesterone Capsules has a good effect in patients after TCRP,which can not only effectively control the level of hemoglobin in the body and improve clinical symptoms,but also effectively regulate the expression level of endometrial tissue,improve endometrial receptivity,and do not increase the postoperative recurrence rate.