孕激素联合宫腔镜手术治疗多发性子宫内膜息肉及术后复发分析

Clinical efficacy of progesterone combined with hysteroscopic surgery for treating women with multiple endometrial polyps and its effect on postoperative recurrence

目的:探讨孕激素联合宫腔镜手术治疗多发性子宫内膜息肉临床疗效及对术后复发的影响。方法:将106例多发性子宫内膜息肉患者随机分为两组,观察组(53例)采用宫腔镜手术切除子宫内膜息肉并术后口服孕激素10d,对照组(53例)仅行宫腔镜手术。观察两组术后月经量、月经期、血红蛋白水平、子宫内膜厚度、子宫内膜息肉复发率的差异。结果:两组患者治疗后月经量、月经期、子宫内膜厚度均减少(P<0.05)、血红蛋白增高(P<0.05)。观察组治疗后3个月、6个月、12个月的月经量、月经期均短于对照组,血红蛋白水平高于对照组,子宫内膜厚度小于对照组,月经改善率均高于对照组,治疗后6个月、12个月复发率(1.9%、3.8%)低于对照组(3.8%、16.9%)(均P<0.05)。两组治疗后妊娠率未见差异(64.7%、65.7%)(P>0.05),观察组不良反应率(3.8%)与对照组(0.0%)对比未见差异(P=0.153)。结论:孕激素联合宫腔镜手术可显著改善多发性子宫内膜息肉患者月经,降低子宫内膜厚度、抑制复发,且不增加并发症风险,效果优于单独宫腔镜手术治疗。

Objective:To investigate the clinical efficacy of progesterone combined with hysteroscopic surgery for treating women with multiple endometrial polyps,and to study the treatment of the operation on postoperative recurrence.Methods:106 women with multiple endometrial polyps were randomly divided into two groups.The women in the study group(53 patients)were given progestogen pills orally administered for 10 days after hysteroscopic surgery,and the women in the control group(53 patients)were given hysteroscopic surgery only.The postoperative menstrual amount,the time of menstrual period,the hemoglobin level,the endometrial thickness,and the endometrial polyp recurrence rate of women were compared between the two groups.Result:After surgery,the postoperative menstrual amount,the time of menstrual period,and the endometrial thickness were decreased significantly and hemoglobin level increased significantly(P<0.05).3 months,6 months,and 12 months after treatment,the menstrual amount and the time of menstrual cycle of women in the study group were significant shorter than those of women in the control group(P<0.05),the hemoglobin level was significant higher(P<0.05),the endometrial thickness was significant lower(P<0.05),and the menstrual improvement rate was significant higher(P<0.05).The recurrence rates of women in the study group(5.7%and 13.2%)at 6 months and 12 months after treatment were significant lower than those(22.6%and 30.2%)of women in the control group(P<0.05).There were no significant differences in pregnancy rate after treatment(64.7%vs.65.7%,P>0.05)and the adverse reaction rate(3.8%vs.0.0%,P=0.153)between the two groups.Conclusion:Progesterone combined with hysteroscopy for treating women with multiple endometrial polyps can significantly improve the menstruation situation of women,reduce the endometrial thickness,inhibit recurrence,and do not increase the risk of complications,which has better efficacy than that of treatment by hysteroscopy alone.