宫腔镜下子宫内膜息肉切除术后应用不同类型药物预防复发的疗效分析

Analysis of the efficacy of different types of drugs in preventing recurrence after hysteroscopic endometrial polypectomy

目的研究宫腔镜下子宫内膜息肉切除术后应用不同类型药物预防复发的疗效。方法 90例宫腔镜下子宫内膜息肉切除术后患者,随机分为甲组、乙组、丙组,各30例。甲组患者采取屈螺酮炔雌醇药物治疗,乙组患者采取地屈孕酮药物治疗,丙组患者采取孕三烯酮药物治疗。比较三组患者的治疗效果、子宫内膜厚度、子宫内膜息肉复发情况以及不良反应发生情况。结果丙组患者的总有效率为96.7%,高于甲组的80.0%及乙组的76.7%,差异具有统计学意义(P<0.05)。甲组及乙组的总有效率比较,差异无统计学意义(P>0.05)。三组术后6、12、24个月的子宫内膜厚度比较,差异均具有统计学意义(P<0.05)。丙组术后6、12、24个月的子宫内膜厚度均低于甲组及乙组,差异均具有统计学意义(P<0.05)。三组患者术后6个月均无子宫内膜息肉复发;术后12、24个月丙组子宫内膜息肉复发率显著低于甲组及乙组,差异均具有统计学意义(P<0.05)。甲组及乙组的子宫内膜息肉复发率比较,差异无统计学意义(P>0.05)。甲组不良反应发生率为20.0%,高于乙组的3.3%及丙组的3.3%,差异均具有统计学意义(P<0.05)。乙组及丙组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论宫腔镜下子宫内膜息肉切除术后患者采用孕三烯酮药物治疗,对患者的病情有更好的控制,有利于提高治疗效果,促进患者身体恢复,降低不良反应发生率,减轻患者痛苦,并且孕三烯酮对远期复发预防效果更好。

Objective To study the efficacy of different types of drugs in preventing recurrence after hysteroscopic endometrial polypectomy.Methods A total of 90 patients with hysteroscopic endometrial polypectomy were randomly divided into group A,group B and group C,with 30 cases in each group.Group A was treated with drospirone ethinylestradiol,group B was treated with didrogesterone,and group C was treated with gestrinone.Comparison were made on treatment effect,endometrial thickness,recurrence of endometrial polyps and occurrence of adverse reactions among three groups.Results Group C had higher total effective rate as 96.7%than 80.0%in group A and 76.7%in group B.Their difference was statistically significant(P<0.05).Group A and group B had no statistically significant difference in total effective rate(P>0.05).Three groups had statistically significant difference in endometrial thickness after 6,12 and 24 months of treatment(P<0.05).Group C had lower endometrial thickness after 6,12 and 24 months of treatment than group A and group B.Their difference was statistically significant(P<0.05).There was no recurrence of endometrial polyps in the three groups 6 months after operation.After 12 and 24 months of treatment,group C had significantly lower recurrence rate of endometrial polyps than group A and group B,and their difference was statistically significant(P<0.05).Group A and group B had no statistically significant difference in recurrence rate of endometrial polyps(P>0.05).Group A had higher incidence of adverser reactions as 20.0%than 3.3%in group B and 3.3%in group C,and their difference was statistically significant(P<0.05).Group B and group C had no statistically significant difference in incidence of adverse reactions(P>0.05).Conclusion For patients after hysteroscopic endometrial polypectomy,gestrinone and drug therapy could better control their condition,improve the treatment effect,promote the recovery,reduce the incidence of adverse reactions,and alleviate the pain of patients,and gestrinone shows better preventive effect on long-term recurrence.