宫腔镜子宫内膜息肉电切术联合左炔诺孕酮宫内缓释系统治疗子宫内膜息肉

摘要

Objective To explore the clinical efficacy of endometrial polyp electrotomy under the hysteroscope (TCRP)in combined with levonorgestrel-releasing intrauterine system(LNG-IUS)in the treatment of endometrial polyp( EP). Methods A total of 70 patients with EP were included in the study and randomized into the observation group and the control group. The patients in the control group were performed with TCRP. On this basis,the patients in the observation group were placed with LNG-IUS inside the uterine cavity. The patients in the two groups were given routine anti-infection after operation. The endometrial thickness before operation,1,6,12 months after operation in the two groups was observed. The levels of E2 and P before operation and 12 months after operation were detected. A fol-low-up visit was paid to observe the recurrence 12 months after operation. Results The comparison of endometrial thickness before operation and 1 month after operation was not statistically significant( P﹥0 . 05 ). With the extending of the treatment time,the endometrial thickness was gradually thinned. The endometrial thickness 6 and 12 months af-ter operation in the observation group was significantly less than that in the control group(P﹤0. 05). The levels of E2 and P 12 months after operation were not obviously changed,and the comparison between the two groups was not sta-tistically significant(P﹥0. 05). In the observation group,12 months after operation,2 cases had recurrence,account-ing for 7. 1%,while in the control group,8 had recurrence,accounting for 22. 9%,and the comparison was statistically significant( P﹤0 . 05 ). Conclusion TCRP in combined with intrauterine placement of LNG-IUS in the treatment of EP has a definite therapeutic effect,can effectively enhance the cure rate,reduce the recurrence rate,effectively allevi-ate the pain,is an ideal method to treat EP,and is appropriate for those who have no fertility requirements temporarily or are married with children.%目的：探讨宫腔镜子宫内膜息肉电切术（ TCRP）联合左炔诺孕酮宫内缓释系统（ LNG-IUS）治疗子宫内膜息肉（ EP）的临床疗效。方法选取我院就诊的70例EP患者为研究对象，随机分为观察组和对照组，对照组行TCRP，观察组行TCRP后宫内放置LNG-IUS，2组术后常规抗感染治疗。观察2组术前及术后第1、6、12个月子宫内膜厚度，检测术前及术后12个月血清雌二醇（ E2）、孕酮（ P）变化，随访术后12个月复发情况。结果术前及术后1个月2组子宫内膜厚度无统计学意义（ P﹥0.05）；随着治疗时间延长，子宫内膜逐渐变薄，术后6、12个月观察组子宫内膜厚度较对照组同期缩小（ P﹤0.05）；术后12个月E2、P水平无明显变化（ P﹥0.05）；术后12个月观察组2例复发，占7.1％，对照组8例复发，占22.9％（ P﹤0.05）。结论 TCRP联合宫内放置LNG-IUS治疗EP，能有效提高治愈率，降低复发率，适用于暂无生育需要或已婚已育EP患者。