左炔诺孕酮宫内缓释系统预防子宫内膜息肉复发的应用

摘要

Objective:To explore the effect of levonorgestrel releasing intrauterine system (LNG IUS) and gestrinone for prevention functional endometrial polyps,and to compare advantage,disadvantages,and pregnancy outcomes between the two different methods.Methods:Patients with functional endometrial polyps who had fertility requirements were divided into two groups according to the treatments methods,and 30 cases in LNG IUS group or in gestrinone group.All included women had experienced hysteroscopic electroresection.Three to five days after surgery,women in LNG IUS group were inserted LNG IUS,and women in gestrinone group took gestrinone orally,2.5mg each time,twice every week,for 3 months.Results:After followed up for three months,the recurrence rate of women in LNG IUS group was 0％ (0/30),while 13.3％ in the gestrinone group was 13.3％(4/30).After followed up for 1 year,the recurrence rate of women in LNG IUS group was 3.3％ (1/30),while 33.3％ in the gestrinone group (10/30).After followed up for 2 years,the recurrence rate of women in LNG IUS group was 10.0％ (3/30),while 53.3％ in the gestrinone group (16/30),which all had statistically significant differences between the two group (P＜0.05).There were no significant differences in accumulated recurrence rate and pregnant rate between the two groups (P ＞ 0.05).Conclusion:Since the effects of LNG IUS for treating functional endometrial polyps is better than that of gestrinone,it is worthy of clinical promotion.%目的:应用左炔诺孕酮宫内缓释系统(LNG-IUS,商品名曼月乐)与孕三烯酮预防功能性子宫内膜息肉,比较这两种治疗的优劣以及对妊娠结局的影响.方法:将60例有生育要求且合并功能性子宫内膜息肉患者按放置曼月乐或孕三烯酮药物治疗分曼月乐组和对照组.两组患者于宫腔镜下电切除术(HPE)后3～5 d开始治疗方案,曼月乐组放置LNG-IUS;对照组患者口服孕三烯酮2.5 mg/次,2次/周.连续治疗3个月.结果:3个月后曼月乐组子宫内膜息肉复发率为0％(0/30),对照组为13.3％(4/30);1年后复发率曼月乐组为3.3％(1/30),对照组为33.3％(10/30);2年复发率曼月乐组为10.0％ (3/30),对照组为53.3％(16/30),曼月乐组与对照组比较差异均有统计学意义(P＜0.05).结论:曼月乐IUS预防功能性子宫内膜息肉复发的效果优于孕三烯酮,值得临床应用.