目的探讨宫腔镜下子宫内膜息肉切除术(Trans-Cervical Resection of Polyps,TCRP)联合曼月乐(Mirena)环放置对子宫内膜息肉术后不良反应和复发率的影响。方法方便选取2019年1月—2022年12月在福州经济技术开发区医院收治的102例子宫内...目的探讨宫腔镜下子宫内膜息肉切除术(Trans-Cervical Resection of Polyps,TCRP)联合曼月乐(Mirena)环放置对子宫内膜息肉术后不良反应和复发率的影响。方法方便选取2019年1月—2022年12月在福州经济技术开发区医院收治的102例子宫内膜息肉患者为研究对象,采用随机数表法分为两组,每组51例,均接受TCRP治疗。术后,研究组放置曼月乐环,对照组给予地屈孕酮片,比较两组术前、术后6个月的子宫内膜厚度、月经量、雌孕激素代谢指标、简明女性性功能指数各维度评分,以及不良反应发生情况和复发情况。结果术后6个月,两组子宫内膜厚度、月经失血图评分及腺体、间质雌激素受体、孕激素受体较术前均降低,且研究组低于对照组,差异有统计学意义(P均<0.05)。研究组术后6个月的性生活质量高于对照组,差异有统计学意义(P<0.05)。研究组复发率(1.96%)低于对照组(13.73%),差异有统计学意义(χ^(2)=4.883,P<0.05)。结论TCRP治疗后,放置曼月乐环可减少子宫内膜厚度,改善机体的月经和雌孕激素代谢情况,提高性生活质量和预后质量。展开更多
Background: The use of intrauterine device alters the normal balance between vaginal flora. It might change cervicovaginal environment, which was suggested to increase the risk for vulvovaginitis. It was found that up...Background: The use of intrauterine device alters the normal balance between vaginal flora. It might change cervicovaginal environment, which was suggested to increase the risk for vulvovaginitis. It was found that up to 85% of levonorgestrel-releasing intrauterine system users become amenorrheic 4 months after insertion, or bleed only sporadically. It was hypothesized that this would have a beneficial effect on vaginal flora maintaining normal balance. Objectives: The aim of this study was to detect the effect of hormonal intrauterine system (“Mirena”: 20 microgram/24 hours intrauterine delivery system Levonorgestrel) on vaginal flora by using pap smear before and 6 months after insertion. Study design: A prospective cohort study was carried out in a university maternity hospital. 210 subjects were included with pap smear taken at time of insertion of IUS “Mirena” and another one taken 6 months later to detect percentage of incidence of infection in IUS users. Vaginal flora was studied, and lactobacilli were graded according to Schr?der’s classification. A comparison was made to allow detection of changes in vaginal flora caused by presence of hormonal IUS “Mirena”. Results: Over half of cases (57.2%) showed worse vaginal flora after hormonal IUS “Mirena” insertion than before. There was a highly statistically significant difference between Schr?der’s Grades before and after insertion (P value < 0.001) as 44.8% of cases presented by Grade I, 44.4% of cases presented by grade IIa, 38% of cases presented by grade IIb before insertion developed Grade III after insertion. Conclusion: Insertion of hormonal IUS “Mirena” results in significant change in microbial flora towards pathological bacteria.展开更多
BACKGROUND Improper methods of contraception greatly increase the risk of abortion,cervical or endometrial lesions,and the number of recurrent artificial abortions.These complications result in the deterioration of a ...BACKGROUND Improper methods of contraception greatly increase the risk of abortion,cervical or endometrial lesions,and the number of recurrent artificial abortions.These complications result in the deterioration of a patient’s outcome.Further,the proportion of artificial abortions is highest among unmarried females.Placement of an intrauterine device,such as the Mirena,after an artificial abortion may decrease the likelihood of an endometrial injury caused by recurrent abortions while significantly improving its contraceptive effects.AIM To discuss the effect of Mirena placement on reproductive hormone levels at different time points after an artificial abortion.METHODS Women(n=119)undergoing an artificial abortion operation were divided into the study(n=56)and control(n=63)groups.In the study group,the Mirena was inserted immediately after the artificial abortion,whereas in the control group,it was inserted 4–7 d after the onset of the first menstrual cycle after abortion.All participants were followed-up for 6 mo to observe the continuation and expulsion rates and adverse reactions and to measure the levels of serum estradiol(E2),follicle stimulating hormone(FSH),and luteinizing hormone(LH).RESULTS The continuation rates were 94.64%and 93.65%in the study group and the control group,respectively.The expulsion rates were 1.79%and 3.17%in the study group and the control group,respectively.There was no statistically significant difference between the two groups(P>0.05).There were also no statistically significant differences in the proportion of patients with bacterial vaginitis,trichomonas vaginitis,or cervicitis between the groups(P>0.05).Six months after Mirena placement,E2 Levels were 45.50±7.13 pg/mL and 42.91±8.10 pg/mL,FSH 13.60±3.24 mIU/mL and 14.54±3.11 mIU/mL,and LH 15.11±2.08 mIU/mL and 14.60±3.55 mIU/mL in the study and control groups,respectively.There were no significant differences in hormone levels between the two groups(P>0.05).There were also no statistically significant differences in the proportions of abnormal menstruation,prolonged menstruation,or pain during intercourse between the study and control groups after Mirena placement(P>0.05).There were no statistically significant differences in uterine volume,sexual desire,sexual activity,or the sexual satisfaction score between the study and control groups before and after Mirena placement(P>0.05).CONCLUSION Placement of a Mirena intrauterine device immediately after an artificial abortion does not increase the risk of adverse reactions and can help prevent endometrial injury caused by recurrent abortions.展开更多
目的探讨子宫内膜息肉(endometrial polyps,EPs)患者行宫腔镜息肉切除术(transcervical resection of polyp,TCRP)后应用不同治疗方案的临床效果。方法方便选取高州市人民医院2019年1—12月就诊的EPs患者120例为研究对象,采用随机数表...目的探讨子宫内膜息肉(endometrial polyps,EPs)患者行宫腔镜息肉切除术(transcervical resection of polyp,TCRP)后应用不同治疗方案的临床效果。方法方便选取高州市人民医院2019年1—12月就诊的EPs患者120例为研究对象,采用随机数表法分为3组(A、B、C组),各40例。均行TCRP手术治疗,方便A组术后不给予任何治疗措施,B组术后给予达英-35口服治疗,C组术后于宫腔内放置曼月乐治疗。对比3组不同治疗时间段子宫内膜厚度变化、治疗前后月经量改善、EPs复发以及两组用药相关不良反应情况。结果术后3、12个月,3组EPs患者子宫内膜厚度比较,差异有统计学意义(P<0.05);且C组EPs患者子宫内膜厚度较B组、A组更低,差异有统计学意义(P<0.05)。术后3、12个月,3组EPs患者月经量对比,差异有统计学意义(P<0.05);且C组EPs患者月经量较B组、A组更少,差异有统计学意义(P<0.05)。术后3个月,3组EPs患者息肉复发率对比,差异无统计学意义(P>0.05);术后6、12个月,3组EPs患者息肉复发率对比,差异有统计学意义(P<0.05);且C组EPs患者复发率较B组、A组更低,差异有统计学意义(P<0.05)。C组药物相关不良反应发生率(80.00%)明显高于B组(30.00%),差异有统计学意义(χ^(2)=20.202,P<0.05)。结论EPs患者行TCRP治疗后联合宫腔内放置曼月乐治疗方案临床效果显著,可有效降低子宫内膜厚度,改善月经异常症状,降低EPs复发率,存在一定术后不规则流血概率,但不影响临床疗效,且通常量少,安全性较高。展开更多
文摘目的探讨宫腔镜下子宫内膜息肉切除术(Trans-Cervical Resection of Polyps,TCRP)联合曼月乐(Mirena)环放置对子宫内膜息肉术后不良反应和复发率的影响。方法方便选取2019年1月—2022年12月在福州经济技术开发区医院收治的102例子宫内膜息肉患者为研究对象,采用随机数表法分为两组,每组51例,均接受TCRP治疗。术后,研究组放置曼月乐环,对照组给予地屈孕酮片,比较两组术前、术后6个月的子宫内膜厚度、月经量、雌孕激素代谢指标、简明女性性功能指数各维度评分,以及不良反应发生情况和复发情况。结果术后6个月,两组子宫内膜厚度、月经失血图评分及腺体、间质雌激素受体、孕激素受体较术前均降低,且研究组低于对照组,差异有统计学意义(P均<0.05)。研究组术后6个月的性生活质量高于对照组,差异有统计学意义(P<0.05)。研究组复发率(1.96%)低于对照组(13.73%),差异有统计学意义(χ^(2)=4.883,P<0.05)。结论TCRP治疗后,放置曼月乐环可减少子宫内膜厚度,改善机体的月经和雌孕激素代谢情况,提高性生活质量和预后质量。
文摘Background: The use of intrauterine device alters the normal balance between vaginal flora. It might change cervicovaginal environment, which was suggested to increase the risk for vulvovaginitis. It was found that up to 85% of levonorgestrel-releasing intrauterine system users become amenorrheic 4 months after insertion, or bleed only sporadically. It was hypothesized that this would have a beneficial effect on vaginal flora maintaining normal balance. Objectives: The aim of this study was to detect the effect of hormonal intrauterine system (“Mirena”: 20 microgram/24 hours intrauterine delivery system Levonorgestrel) on vaginal flora by using pap smear before and 6 months after insertion. Study design: A prospective cohort study was carried out in a university maternity hospital. 210 subjects were included with pap smear taken at time of insertion of IUS “Mirena” and another one taken 6 months later to detect percentage of incidence of infection in IUS users. Vaginal flora was studied, and lactobacilli were graded according to Schr?der’s classification. A comparison was made to allow detection of changes in vaginal flora caused by presence of hormonal IUS “Mirena”. Results: Over half of cases (57.2%) showed worse vaginal flora after hormonal IUS “Mirena” insertion than before. There was a highly statistically significant difference between Schr?der’s Grades before and after insertion (P value < 0.001) as 44.8% of cases presented by Grade I, 44.4% of cases presented by grade IIa, 38% of cases presented by grade IIb before insertion developed Grade III after insertion. Conclusion: Insertion of hormonal IUS “Mirena” results in significant change in microbial flora towards pathological bacteria.
文摘BACKGROUND Improper methods of contraception greatly increase the risk of abortion,cervical or endometrial lesions,and the number of recurrent artificial abortions.These complications result in the deterioration of a patient’s outcome.Further,the proportion of artificial abortions is highest among unmarried females.Placement of an intrauterine device,such as the Mirena,after an artificial abortion may decrease the likelihood of an endometrial injury caused by recurrent abortions while significantly improving its contraceptive effects.AIM To discuss the effect of Mirena placement on reproductive hormone levels at different time points after an artificial abortion.METHODS Women(n=119)undergoing an artificial abortion operation were divided into the study(n=56)and control(n=63)groups.In the study group,the Mirena was inserted immediately after the artificial abortion,whereas in the control group,it was inserted 4–7 d after the onset of the first menstrual cycle after abortion.All participants were followed-up for 6 mo to observe the continuation and expulsion rates and adverse reactions and to measure the levels of serum estradiol(E2),follicle stimulating hormone(FSH),and luteinizing hormone(LH).RESULTS The continuation rates were 94.64%and 93.65%in the study group and the control group,respectively.The expulsion rates were 1.79%and 3.17%in the study group and the control group,respectively.There was no statistically significant difference between the two groups(P>0.05).There were also no statistically significant differences in the proportion of patients with bacterial vaginitis,trichomonas vaginitis,or cervicitis between the groups(P>0.05).Six months after Mirena placement,E2 Levels were 45.50±7.13 pg/mL and 42.91±8.10 pg/mL,FSH 13.60±3.24 mIU/mL and 14.54±3.11 mIU/mL,and LH 15.11±2.08 mIU/mL and 14.60±3.55 mIU/mL in the study and control groups,respectively.There were no significant differences in hormone levels between the two groups(P>0.05).There were also no statistically significant differences in the proportions of abnormal menstruation,prolonged menstruation,or pain during intercourse between the study and control groups after Mirena placement(P>0.05).There were no statistically significant differences in uterine volume,sexual desire,sexual activity,or the sexual satisfaction score between the study and control groups before and after Mirena placement(P>0.05).CONCLUSION Placement of a Mirena intrauterine device immediately after an artificial abortion does not increase the risk of adverse reactions and can help prevent endometrial injury caused by recurrent abortions.
文摘目的探讨子宫内膜息肉(endometrial polyps,EPs)患者行宫腔镜息肉切除术(transcervical resection of polyp,TCRP)后应用不同治疗方案的临床效果。方法方便选取高州市人民医院2019年1—12月就诊的EPs患者120例为研究对象,采用随机数表法分为3组(A、B、C组),各40例。均行TCRP手术治疗,方便A组术后不给予任何治疗措施,B组术后给予达英-35口服治疗,C组术后于宫腔内放置曼月乐治疗。对比3组不同治疗时间段子宫内膜厚度变化、治疗前后月经量改善、EPs复发以及两组用药相关不良反应情况。结果术后3、12个月,3组EPs患者子宫内膜厚度比较,差异有统计学意义(P<0.05);且C组EPs患者子宫内膜厚度较B组、A组更低,差异有统计学意义(P<0.05)。术后3、12个月,3组EPs患者月经量对比,差异有统计学意义(P<0.05);且C组EPs患者月经量较B组、A组更少,差异有统计学意义(P<0.05)。术后3个月,3组EPs患者息肉复发率对比,差异无统计学意义(P>0.05);术后6、12个月,3组EPs患者息肉复发率对比,差异有统计学意义(P<0.05);且C组EPs患者复发率较B组、A组更低,差异有统计学意义(P<0.05)。C组药物相关不良反应发生率(80.00%)明显高于B组(30.00%),差异有统计学意义(χ^(2)=20.202,P<0.05)。结论EPs患者行TCRP治疗后联合宫腔内放置曼月乐治疗方案临床效果显著,可有效降低子宫内膜厚度,改善月经异常症状,降低EPs复发率,存在一定术后不规则流血概率,但不影响临床疗效,且通常量少,安全性较高。
