地屈孕酮曼月乐预防子宫内膜息肉电切术后复发临床研究.docVIP

地屈孕酮曼月乐预防子宫内膜息肉电切术后复发临床研究 　　[摘要] 目的 观察宫腔镜下子宫内膜息肉切除术（transcervical resection of polyps，TCRP）术后口服地屈孕酮及宫腔放置曼月乐两种方法对预防子宫内膜息肉（endometrial polyps，EMP）复发的疗效。 方法 选择2015年1月～2016年12月本院行TCRP术后经病理证实的患者122例，根据治疗方法随机分为三组，Ⅰ组42例为术后口服地屈孕酮6个月，Ⅱ组40例为术后放置左炔诺孕酮宫内节育系统，Ⅲ组40例为单纯手术组。术后随访 12 个月，观察三组EP复发及子宫异常出血的改善等情况。 结果 Ⅰ组复发率为 4.76%，Ⅱ组复发率为2.50%，Ⅲ组复发率为17.50%，Ⅰ组、Ⅱ组与Ⅲ组比较，差异有统计学意义（P0.05）；术后1、3、6、12 个月Ⅰ组和Ⅱ组月经量少的构成比均明显高于Ⅲ组（P0.01）。 结论 宫腔镜下子宫内膜息肉切除术后口服地屈孕酮或宫腔放置曼月乐均可明显改善经量多的症状，减少子宫内膜息肉的复发。 　　[关键词] 子宫内膜息肉；地屈孕酮；曼月乐；复发 　　[中图分类号] R737.33 [文献标识码] B [文章编号] 1673-9701（2018）07-0097-03 　　[Abstract] Objective To observe the effects of oral dydrogesterone and intrauterine Mirena on the prevention of the relapse of the endometrial polyps（EMP） after transcervical resection of polyps（TCRP）. Methods A total of 122 patients who underwent TCRP and were pathologically confirmed postoperatively in our hospital from January 2015 to December 2016 were randomly divided into 3 groups according to the treatment method. Group Ⅰ（n=42） received oral dydrogesterone for 6 months. Group Ⅱ （n=40） was treated with levonorgestrel intrauterine contraceptive system. Group Ⅲ（n=40） was treated with surgery alone. The patients were followed up for 12 months postoperatively. The relapse of EP and the improvement of abnormal uterine bleeding in 3 groups were observed. Results The recurrence rate was 4.76% in group Ⅰ， 2.50% in group Ⅱ， and 17.50% in group Ⅲ. There was a significant difference between group Ⅰ， group Ⅱ and group Ⅲ（P0.05）. The proportion of hypomenorrhea in group Ⅰ and group Ⅱ at 1， 3， 6 and 12 months after surgery was significantly higher than that in group Ⅲ（P0.01）. Conclusion Oral dydrogesterone or the intrauterine placement of Mirena after hysteroscopic endometrial polypectomy can significantly improve the symptoms of menorrhagia and reduce the relapse of endometrial polyps. 　　[Key words] Endometrial polyps； Dydrogesterone； Mirena； Relapse 　　子?m内膜息肉是妇科常见病，从育龄期到绝经后的女性，均是子宫内膜息肉的高发人群，其主要是由子宫内膜局部过度增生所致，表现为突出于子宫腔内的单个或多个光滑