宫腔镜电切除术联合地屈孕酮片治疗围绝经期子宫内膜息肉致异常子宫出血的效果观察

Observation of therapeutic effect of hysteroscopic resection combined with dydrogesterone tablets on perimenopausal abnormal uterine bleeding caused by endometrial polyps

目的探讨宫腔镜电切除术联合地屈孕酮片治疗围绝经期子宫内膜息肉致异常子宫出血(AUB)的临床疗效。方法分析性研究。抽取2020年6月至2023年6月河南科技大学第二附属医院收治的82例围绝经期子宫内膜息肉致AUB患者为研究对象,采用抽签法随机分为对照组和研究组,每组41例。两组均给予常规护理,对照组予以宫腔镜电切除术治疗,研究组在对照组基础上加用地屈孕酮片治疗。比较两组患者的临床疗效,比较两组治疗前后子宫内膜厚度、月经情况和激素水平[促黄体生成素(LH)、雌二醇(E2)和促卵泡生成素(FSH)]。结果研究组总有效率(95.12%,39/41)高于对照组(75.61%,31/41),P<0.05。治疗后,两组子宫内膜厚度、月经情况均较治疗前显著改善(P<0.05),且研究组子宫内膜、月经改变情况优于对照组(P<0.05)。治疗后,两组LH、E2、FSH水平均较治疗前降低,且研究组LH、E2、FSH水平低于对照组(P<0.05)。结论宫腔镜电切除术联合地屈孕酮片治疗围绝经期子宫内膜息肉致AUB比单一应用电切除术治疗效果更好,能更好地降低子宫内膜厚度,减少月经量,降低复发率,改善激素水平。

Objective To investigate the clinical efficacy of hysteroscopic resection combined with dydrogesterone tablets in the treatment of perimenopausal abnormal uterine bleeding(AUB)caused by endometrial polyps.Methods An analytical study was adopted in this study.A total of 82 patients with perimenopausal AUB caused by endometrial polyps who were treated in the Second Affiliated Hospital of Henan University of Science and Technology from June 2020 to June 2023 were selected as the research subjects,and they were randomly divided into a control group and a study group using a lottery method,with 41 cases in each group.Both groups received routine care;the control group received hysteroscopic resection,and the study group received oral administration of dydrogesterone tablets based on the treatment of the control group.The clinical efficacy of two groups were compared.The endometrial thickness,menstrual status,and levels of hormones,including luteinizing hormone(LH),estradiol hormone(E2)and follicle stimulating hormone(FSH),were compared between the two groups before and after treatment.Results The total effective rate of the study group(95.12%,39/41)was higher than that of the control group(75.61%,31/41),P<0.05.After treatment,the endometrium thickness and menstrual status in both groups were improved compared with the two indicators before treatment(P<0.05),and the changes in endometrium and menstrual status in the study group were better than those in the control group(P<0.05).After treatment,the levels of LH,E2 and FSH in both groups decreased compared with preoperative levels,and the levels of LH,E2 and FSH in the study group were lower than those in the control group(P<0.05).Conclusions Comapred with application of hysteroscopic resection alone,hysteroscopic resection combined with dydrogesterone tablets is more effective in the treatment of perimenopausal AUB caused by endometrial polyps.It can better reduce endometrial thickness,decrease menstrual flow,lower recurrence rate,and improve levels of hormones.