左炔诺孕酮宫内节育系统和地屈孕酮片预防术后子宫内膜息肉复发的效果

Effect of Levonorgestrel Intrauterine Birth Control System and Dydrogesterone Tablet in Preventing Postoperative Recurrence of Endometrial Polyps

目的:探究行宫腔镜下子宫内膜息肉电切除术患者应用左炔诺孕酮宫内节育系统和地屈孕酮片预防术后复发的疗效。方法:选取2021年9月至2022年8月期间海宁市人民医院收治的子宫内膜息肉患者90例,根据随机数字表法将其分为三组。对照组30例给予单独宫腔镜下子宫内膜息肉电切除术治疗,左炔诺孕酮宫内节育系统组30例于对照组基础上在宫腔内放置左炔诺孕酮宫内节育系统治疗,地屈孕酮组30例于对照组基础上给予地屈孕酮片口服治疗。随访12个月,比较三组患者的子宫内膜厚度、月经量及经期时间、术后复发率。结果:治疗3、6、12个月后,左炔诺孕酮宫内节育系统组与地屈孕酮组子宫内膜厚度均低于对照组,差异具有统计学意义(P<0.05);治疗3、6、12个月后,左炔诺孕酮宫内节育系统组与地屈孕酮组患者月经量低于对照组,经期时间短于对照组,差异具有统计学意义(P<0.05);在随访12个月期间,左炔诺孕酮宫内节育系统组与地屈孕酮组患者术后复发率低于对照组,差异具有统计学意义(P<0.05);左炔诺孕酮宫内节育系统组与地屈孕酮组上述指标组间比较,差异无统计学意义(P>0.05)。结论:宫腔镜下子宫内膜息肉电切除术后患者放置左炔诺孕酮宫内节育系统或口服地屈孕酮片均能够有效降低其子宫内膜厚度和术后复发率,并减少月经量及缩短经期时间。

Objective To explore the effect of levonorgestrel intrauterine birth control system and dydrogesterone tablet in preventing postoperative recurrence in patients undergoing hysteroscopic electroresection of endometrial polyps.Methods A total of 90 patients with endometrial polyps admitted to Haining People's Hospital from September 2021 to August 2022 were selected and divided into three groups according to random number table method.Thirty cases in the control group were treated with hysteroscopic electroresection of endometrial polyps alone;thirty cases in the levonorgestrel intrauterine birth control system group were treated with levonorgestrel intrauterine birth control system on the basis of the control group;thirty cases in the dydrogesterone group were treated with dydrogesterone tablet orally on the basis of the control group.After 12 months of follow-up,the endometrial thickness,menstrual volume and duration,postoperative recurrence rate of the three groups were compared.Results After 3,6 and 12 months of treatment,the endometrial thickness of the levonorgestrel intrauterine birth control system group and the dydrogesterone group were lower than those of the control group,the differences were statistically significant(P<0.05).After 3,6 and 12 months of treatment,the menstrual volume in the levonorgestrel intrauterine birth control system group and the dydrogesterone group were lower than those in the control group,and the menstrual duration were shorter than those in the control group,the differences were statistically significant(P<0.05).During the follow-up period of 12 months,the postoperative recurrence rate of the levonorgestrel intrauterine birth control system group and the dydrogesterone group were lower than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the above indexes between the levonorgestrel intrauterine birth control system group and the dydrogesterone group(P>0.05).Conclusion After hysteroscopic electroresection of endometrial polyps,levonorgestrel intrauterine birth control system or oral dydrogesterone tablet can effectively reduce endometrial thickness and postoperative recurrence rate,reduce menstrual volume and shorten menstrual duration.