宫腔镜下子宫内膜息肉切除术联合地屈孕酮治疗子宫内膜息肉的疗效及对预后的影响分析

Analysis of the Efficacy of Transcervical Resection of Polyps Combined with Dydrogesterone in the Treatment of Endometrial Polyps and Its Effect on Prognosis

目的分析宫腔镜下子宫内膜息肉切除术(transcervical resection of polyps,TCRP)联合地屈孕酮的疗效及对预后的影响。方法随机选取2020年7月—2023年6月宜兴市中医医院妇产科收治的100例子宫内膜息肉患者为研究对象,根据不同治疗方法分成对照组和观察组,各50例。两组均行TCRP治疗,对照组术后行黄体酮治疗,观察组术后行地屈孕酮治疗。对比两组手术前后子宫内膜指标、月经量、血红蛋白水平、子宫异常出血率变化及术后复发率。结果术后第6个月,观察组子宫内膜指标水平低于对照组,差异有统计学意义(P<0.05)。术后第6个月,观察组月经失血图评分、血红蛋白水平优于对照组,差异有统计学意义(P均<0.05)。术前及术后6个月、12个月,两组子宫异常出血率对比,差异无统计学意义(P均>0.05)。术后6个月、9个月,两组复发率对比,差异无统计学意义(P均>0.05),术后12个月观察组复发率为6.00%(3/50),低于对照组的22.00%(11/50),差异有统计学意义(χ2=5.316,P=0.021)。结论TCRP联合地屈孕酮治疗,可进一步改善子宫内膜,降低月经量,提高血红蛋白水平,减少子宫异常出血和子宫内膜息肉复发。

Objective To analyze the efficacy of transcervical resection of polyps(TCRP)combined with dydrogesterone and its effect on prognosis.Methods A total of 100 patients with endometrial polyps admitted to the Department of Obstetrics and Gynecology of Yixing Traditional Chinese Medicine Hospital from July 2020 to June 2023 were randomly selected as the research objects.According to different treatment methods,they were divided into control group and observation group,with 50 cases in each group.Both groups were treated with TCRP,the control group was treated with progesterone after operation,and the observation group was treated with dydrogesterone after operation.The changes of endometrial index,menstrual volume,hemoglobin level,abnormal uterine bleeding rate and postoperative recurrence rate before and after operation were observed and compared.Results At 6 months after operation,the endometrial index level of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).At the 6 month after operation,the pictorial blood loss assessment chart score and hemoglobin level in the observation group were better than those in the control group,and the differences were statistically significant(both P<0.05).There was no significant difference in the rate of abnormal uterine bleeding between the two groups before operation,6 months and 12 months after operation(both P>0.05).At 6 months and 9 months after opera tion,there was no significant difference in the recurrence rate between the two groups(both P>0.05).At 12 months af ter operation,the recurrence rate of the observation group was 6.00%(3/50),which was lower than that of the control group 22.00%(11/50),the difference was statistically significant(χ2=5.316,P=0.021).Conclusion TCRP combined with dydrogesterone can further improve the endometrium,reduce menstrual flow,increase hemoglobin level,and re duce abnormal uterine bleeding and recurrence of endometrial polyps.