新疆医科大学学报

目的比较宫腔镜下子宫内膜息肉切除术(transcervical resection of polyps,TCRP)后口服孕三烯酮及宫腔放置曼月乐预防子宫内膜息肉复发的临床疗效。方法选择2013年1月-2014年1月行宫腔镜检查+TCRP并经病理诊断证实的子宫内膜息肉患者103例,术后根据治疗方法不同分为3组:对照组35例,孕三烯酮组38例,曼月乐组30例,比较3组息肉复发、子宫异常出血的改善情况及子宫内膜厚度的情况。结果术后6个月,对照组复发14例(40.00%),孕三烯酮组复发6例(15.79%),曼月乐组0例(0.00%),孕三烯酮组复发率高于曼月乐组,差异有统计学意义(P<0.05),对照组复发率高于孕三烯酮组,差异有统计学意义(P<0.05);3组子宫异常出血改善情况差异无统计学意义(χ2=0.551,P=0.759);术后1个月3组子宫内膜厚度差异无统计学意义(P>0.05),但术后3个月曼月乐组、孕三烯酮组与对照组子宫内膜厚度比较差异有统计学意义(P<0.05),术后6个月曼月乐组与对照组子宫内膜厚度比较差异有统计学意义(P<0.05),孕三烯酮组与对照组比较子宫内膜厚度差异无统计学意义(P>0.05)。结论 TCRP联合曼月乐治疗息肉能减少子宫内膜厚度,并降低子宫内膜息肉复发率,是治疗和预防子宫内膜息肉安全而有效的方法。

Objective To compare the curative effects of oral administration of gestrienone and the placement of LNG-IUS into uterine cavity on the prevention of recurrence of endometrial polyps(EP)after transcervical resection of polyps(TCRP).Methods Selected 103 patients with EP from January 2013 to January 2014 in our hospital,to divide into 3groups according to different treatments after TCRP:35cases in control group,38 cases in gestrienone group and 30 cases in LNG-IUS group.The recurrence of EP,the improvement of abnormal hemorrhage and the thickness of endometrium were compared among the three groups.Results The percentage of recurrence rate of the LNG-IUS group and gestrienone group were 0% and 15.79%,respectively,which were significantly lower than the percentage of the control group 40%(P <0.05).No significant difference among the three groups was observed in the improvement of abnormal hemorrhage(χ2=0.551,P =0.759).The endometrium thickness was no significant difference among the three groups after treatment at 1month(P >0.05);The difference was significant in gestrienone group and LNG-IUS group compared to control group after treatment at 3months(P <0.05);The difference was significant between LNG-IUS group and control group after treatment at 6months(P<0.05);No significant difference between gestrienone group and the control group was observed after treatment at 6month(P >0.05).Conclusion The placement of LNG-IUS into uterine cavity after TCRP could effectively prevent the recurrence of EP and decrease the endometrium thickness,which was also a safe and effective way to treat and prevent the endometrial polyp.