地屈孕酮片与左炔诺孕酮宫内节育系统对宫腔镜子宫内膜息肉切除术后疗效的对比研究

A Comparative Study on the Efficacy of Dydrogesterone Tablets and Levonorgestrel Intrauterine System after Transcervical Resection of Polyps

目的:比较地屈孕酮片与左炔诺孕酮宫内节育系统(曼月乐)对行宫腔镜子宫内膜息肉切除术(TCRP)后患者的疗效。方法:选取2019年1月—2021年12月深圳市福田区妇幼保健院妇科346例TCRP后患者随机分为对照组(173例)和观察组(173例),对照组患者术后口服地屈孕酮片,观察组患者术后在宫腔内放置曼月乐,两组均持续随访12个月。比较两组月经量[月经失血图(PBAC)评分]、子宫内膜厚度、血红蛋白;比较两组孕激素受体(PR)、表皮生长因子(EGF)、雌激素受体(ER)表达水平;比较两组复发率及不良反应发生率。结果:术后12个月,观察组患者PBAC评分、子宫内膜厚度和EGF、ER、PR表达水平均低于对照组,血红蛋白水平高于对照组(P<0.05)。观察组复发率、不良反应发生率均明显低于对照组(P<0.05)。结论:曼月乐有助于降低TCRP术后患者的EGF、ER和PR表达水平,从而改善患者临床症状,减少术后不良反应发生率,且有效预防术后子宫内膜息肉复发。

Objective:To compare the efficacy of Dydrogesterone Tablets and Levonorgestrel intrauterine system(Mirena)in patients after transcervical resection of polyp(TCRP).Method:A total of 346 postoperative patients with TCRP in the Gynecology Department of Shenzhen Futian District Maternity&Child Health Hospital from January 2019 to December 2021 were randomly divided into control group(173 cases)and observation group(173 cases).Patients in the control group were orally administered Dydrogesterone Tablets after surgery,and patients in the observation group were implanted with Mirena in the uterine cavity after surgery.Both groups were followed up for 12 months.Menstrual volume[pictorial blood loss assessment chart(PBAC)score],endometrial thickness,hemoglobin were compared between the two groups.The expression levels of progesterone receptor(PR),epidermal growth factor(EGF)and estrogen receptor(ER)were compared between the two groups.The recurrence rate and the incidence of adverse reactions were compared between the two groups.Result:Twelve months after surgery,PBAC score,endometrial thickness and EGF,ER,PR expression levels in observation group were lower than those in control group,and hemoglobin level was higher than that in control group(P<0.05).The recurrence rate and incidence of adverse reactions in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Mirena helps to reduce EGF,ER and PR expression levels in patients after TCRP,thereby improving clinical symptoms,reducing the incidence of postoperative adverse reactions,and effectively preventing postoperative endometrial polyp recurrence.