地屈孕酮、曼月乐预防子宫内膜息肉电切术后复发的临床研究

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地屈孕酮、曼月乐预防子宫内膜息肉电切术后复发的临床研究

作者：肖静江如郭晨

来源：《中国现代医生》2018年第07期

[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（P

[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（P

[Key words] Endometrial polyps； Dydrogesterone； Mirena； Relapse

子宫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肿物，蒂长短不一。可引起不规则阴道流血、不孕等。子宫内膜息肉偶有恶变，尤其是绝经后阴道流血者。子宫内膜息肉以超声诊断为主，宫腔镜是诊断子宫内膜息肉的金标准，宫腔镜下息肉切除术是子宫内膜息肉首选的治疗方法[1]，但息肉易复发。如何有效地预防子宫内膜息肉复发是