左炔诺孕酮宫内缓释系统预防子宫内膜息肉术后复发的研究

摘要

Objective: To explore the clinical effect of a levonorgestrel intrauterine system ( LNG - IUS) on prevention of en-dometrial polyp recurrence after endometrial polyp resection by hysteroscopy. Methods: Three hundred and three women after endometrial polyp resection by hysteroscopy were randomly divided into two groups. Women in the treatment group (n = 152) had a LNG - IUS insertion immediately after hysteroscopy. There were 103 cases of solitary endometrial polyp and 49 cases of multiple endometrial polyps in the treatment group, and 111 cases of solitary endometrial polyp and 40 cases of multiple endometrial polyps in the control group. Women were followed up for 3 years. Results: No endometrial polyp recurrence were found in the treatment group. In the control group, the endometrial polyp recurrence was found in 31 women (20.5% ) , 17 cases of solitary endometrial polyp and 14 cases of multiple endometrial polyps. There was statistically significant difference in the incidence of endometrial polyp recurrence between the two groups (P<0. 05). No hypoestrogenic symptoms, acne, hirsutism, and abnormal liver and renal functions as well as lipid metabolism were found throughout the following - up period. Conclusion ; A LNG - IUS could prevent the endometrial polyp recurrence after hysteroscopy.%目的:探讨左炔诺孕酮宫内缓释系统( LNG - IUS)预防宫腔镜子宫内膜息肉切除术后复发的临床疗效.方法:采用前瞻性随机对照研究,将303例宫腔镜子宫内膜息肉切除术(TCRP)后妇女分为两组,治疗组152例,TCRP术后立即放置LNG - IUS,其中单发性息肉103例,多发性息肉49例；对照组151例,TCRP术后无任何处理措施,其中单发性息肉111例,多发性息肉40例,门诊随访3年.结果:治疗组中无一例复发,对照组中单发性息肉有17例复发,多发性息肉有14例复发,总复发率为20.5％ (31/151),两组复发率差异有统计学意义(P＜0.05).在随访期间,治疗组无一例患者出现低雌激素症状、痤疮、多毛或肝肾功能、脂代谢异常.结论:LNG - IUS能有效地预防子宫内膜息肉切除术后的复发.