口服地屈孕酮与宫内放置曼月乐环对预防子宫内膜息肉患者宫腔镜术后复发的对比研究

Comparative study of oral desdrogesterone and intrauterine placement of Mirena ring in the prevention of recurrence in patients with endometrial polyps after hysteroscopic surgery

目的:对比分析口服地屈孕酮与宫内放置曼月乐环两种方法对预防子宫内膜息肉患者宫腔镜术后复发的应用效果。方法:选择本院于2021年3月至2022年9月期间在门诊收治的76例子宫内膜息肉患者。采用简单数字表法将患者随机分为研究组与对照组,两组人数均38例。所有患者均接受宫腔镜电切术,术后对照组予以地屈孕酮治疗,研究组予以曼月乐内放置治疗。门诊追踪随访6m。比较两组术后复发率、子宫内膜厚度、不良反应。结果:宫腔镜电切术后1m,两组患者复发率比较无明显差异(P>0.05),术后3m、6m研究组复发率均低于对照组(P<0.05)。子宫内膜厚度比较,研究组术后1m、3m、6m子宫内膜厚度均较对照组薄(P<0.05)。研究组不良反应发生率7.90%,对照组不良反应发生率26.32%,研究组明显较对照组低(P<0.05)。结论:对子宫内膜息肉宫腔镜术患者而言,相较于术后口服地屈孕酮,采用曼月乐内放置治疗能有效降低术后复发率,使子宫内膜厚度变薄,不良反应发生风险降低。

Objective:To compare the efficacy of oral desdrogesterone and intrauterine placement of Mirena ring in the prevention of recurrence of endometrial polyps after hysteroscopic surgery.Methods:A total of 76 patients with endometrial polyps who were admitted to our hospital from March 2021 to September 2022 were selected.The patients were randomly divided into study group and control group with 38 cases in both groups.All patients underwent hysteroscopic electroresection.The control group was treated with desdrogesterone and the study group was treated with Mirena placement.Outpatient follow-up for 6 months.The recurrence rate,endometrial thickness and adverse reactions were compared between the two groups.Results:1 month after hysteroscopic resection,there was no significant difference in the recurrence rate between the two groups(P>0.05),and the recurrence rate of the study group was lower than that of the control group at 3 months and 6 months after surgery(P<0.05).The endometrial thickness of the study group was thinner than that of the control group at 1 month,3 months and 6 months after operation(P<0.05).The incidence of adverse reactions was 7.90%in the study group and 26.32%in the control group,which was significantly lower than that in the control group(P<0.05).Conclusion:For patients with endometrial polyps undergoing hysteroscopy,compared with oral desdrogesterone after surgery,mirenolone placement can effectively reduce the postoperative recurrence rate,the endometrial thickness becomes thinner,and the risk of adverse reactions is reduced.