曼月乐预防宫腔镜下子宫内膜息肉切除术后息肉复发的疗效观察

发布时间：2018-05-05 18:45

本文选题：TCRP + 子宫内膜息肉　；参考：《青岛大学》2014年硕士论文

【摘要】：目的：观察宫腔镜下子宫内膜息肉电切术(transcervical resection of endometrial polyps, TCRP)后放置左炔诺孕酮宫内缓释系统(levonorgestrel-releasing intrauterine system, LNG-IUS,商品名Mirena)预防子宫内膜息肉(endometrial polyps)复发的疗效。方法：收集本院近期经宫腔镜诊治的子宫内膜息肉的病例315例,其中单纯性子宫内膜息肉198例,子宫内膜息肉合并子宫腺肌病38例,子宫内膜息肉合并子宫肌瘤40例,乳腺癌术后口服他莫昔芬合并子宫内膜息肉39例,行子宫内膜息肉电切术后,单纯性子宫内膜息肉(A组)中随机分为三组,研究组①(TCRP+曼月乐)65例,宫腔镜下内膜息肉切除术后放置左炔诺孕酮宫内缓释系统；研究组②(TCRP+甲羟孕酮)68例,宫腔镜下内膜息肉切除术后于术后第一次月经的第15天口服醋酸甲羟孕酮10mg／d,连服10天,重复上述方法3月；对照组(TCRP)65例,宫腔镜下内膜息肉切除术后无任何治疗措施。比较3组患者12个月子宫内膜息肉复发率。其余患者(即合并其它疾病者为B组)117例,行宫腔镜下子宫内膜息肉切除术后,随机分为二组,研究组(TCRP+曼月乐)59例,宫腔镜下内膜息肉切除术后放置左炔诺孕酮宫内缓释系统；对照组58例,宫腔镜下内膜息肉切除术后无任何治疗措施。比较2组患者12个月子宫内膜息肉复发率。结果：A组单纯性子宫内膜息肉组三组(即研究组①、研究组②、对照组)复发率分别为0%,6.45%,24.62%,研究组①(TCRP+曼月乐)、研究组②(TCRP+甲羟孕酮)分别与对照组比较,子宫内膜息肉复发率均明显降低(P0.05),差异有统计学意义；研究组①(TCRP+曼月乐)子宫内膜息肉复发率明显低于研究组②(TCRP+甲羟孕酮)(P0.05),差异有统计学意义。B组中曼月乐组复发率为1.7%,对照组复发率为25.85%,两组比较差异有统计学意义(P0.05)。结论：宫腔镜下子宫内膜息肉切除术联合左炔诺孕酮宫内缓释系统能有效预防子宫内膜息肉复发。
[Abstract]:Objective: to observe the efficacy of levonorgestrel-releasing intrauterine system (LNG-IUSS) in preventing the recurrence of endometrial polyps by transcertial resection of endometrial polyps, TCRP). Methods: a total of 315 cases of endometrial polyps, including 198 cases of simple endometrial polyps, 38 cases of endometrial polyps with adenomyosis and 40 cases of endometrial polyps with uterine leiomyoma, were collected. Thirty-nine patients with endometrial polyps were treated with tamoxifen combined with endometrial polyps after operation. The patients were randomly divided into three groups: group A, simple endometrial polyp after resection of endometrial polyps, and study group (n = 65). After hysteroscopic resection of endometrial polyps, levonorgestrel was placed in the intrauterine release system. The study group included 68 patients with 2(TCRP medroxyprogesterone, and 10 mg / d of medroxyprogesterone acetate was taken orally after hysteroscopic resection of endometrial polyps on the 15th day of the first menstrual period after hysteroscopy, 10 mg / d of medroxyprogesterone acetate was administered for 10 days. The results showed that 65 cases of TCRP were treated with hysteroscopic resection of endometrial polyps without any treatment. To compare the recurrence rate of endometrial polyps in 3 groups at 12 months. The remaining patients (group B, 117 patients with other diseases) were randomly divided into two groups after hysteroscopic resection of endometrial polyps. After hysteroscopic resection of endometrial polyps, levonorgestrel was placed in the intrauterine release system, while in the control group, there was no treatment after hysteroscopic resection of endometrial polyps. The recurrence rate of endometrial polyps at 12 months was compared between the two groups. Results the recurrence rates of simple endometrial polyp group (study group 1, study group 2, control group) were 0, 6.45 and 24.62, respectively. 1(TCRP and 2(TCRP in study group were compared with those in control group. The recurrence rate of endometrial polyps decreased significantly (P 0.05). The recurrence rate of endometrial polyps in the study group was significantly lower than that in the study group (2(TCRP medroxyprogesterone) P0.05.The difference was statistically significant. In group B, the recurrence rate of Manyue group was 1.7 and that of control group was 25.85. The difference between the two groups was statistically significant (P 0.05). Conclusion: hysteroscopic resection of endometrial polyps combined with levonorgestrel intrauterine slow release system can effectively prevent the recurrence of endometrial polyps.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R713.4

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