宫腔镜术后放置左炔诺孕酮宫内缓释系统与口服地屈孕酮治疗子宫内膜息肉患者的效果比较

目的:比较宫腔镜术后放置左炔诺孕酮宫内缓释系统与口服地屈孕酮治疗子宫内膜息肉患者的效果。方法:回顾性分析2018年4月至2019年4月该院收治的80例子宫内膜息肉患者的临床资料,根据患者术后用药不同分为对照组和观察组各40例。两组患者均在宫腔镜下切除息肉,对照组术后口服地屈孕酮片治疗,观察组在术后放置左炔诺孕酮宫内缓释系统治疗。比较两组治疗前后子宫内膜厚度、血红蛋白水平、月经失血图(PBAC)评分、复发率及不良反应发生情况。结果:术后1周,两组子宫内膜厚度均低于术前,但组间比较,差异无统计学意义(P>0.05)。术后6个月,观察组子宫内膜厚度、PBAC评分均明显低于对照组,血红蛋白水平明显高于对照组,差异均有统计学意义(P<0.05)。术后1年,观察组复发率为2.50%(1/40),低于对照组的20.00%(8/40),差异有统计学意义(P<0.05)。观察组不良反应发生率为7.50%(3/40),低于对照组的27.50%(11/40),差异有统计学意义(P<0.05)。结论:宫腔镜术后放置左炔诺孕酮宫内缓释系统治疗子宫内膜息肉患者的效果较好,可改善患者月经情况,抑制子宫内膜增生,降低复发率、贫血及不良反应发生率,效果优于口服地屈孕酮片。

Comparison of effects of Levonorgestrel-releasing intrauterine system and oral Dydrogesterone on patients with endometrial polyps after hysteroscopic surgeries

Objective:To compare effects of Levonorgestrel-releasing intrauterine system and oral Dydrogesterone on patients with endometrial polyps after hysteroscopic surgeries.Methods:The clinical data of 80 patients with endometrial polyps admitted to our hospital from April 2018 to April 2019 were retrospectively analyzed.According to different postoperative medication,these patients were divided into control group and observation group,40 cases in each.Both groups underwent hysteroscopic resection of polyps.After the surgery,the control group was treated with oral Dydrogesterone tablets,while the observation group was treated with Levonorgestrel-releasing intrauterine system.The endometrial thickness,the hemoglobin level,the menstrual blood loss assessment chart(PBAC)score,the recurrence rate and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:One week after the surgery the endometrial thickness levels in both groups were lower than those before the surgery,but there was no significant difference between the two groups(P>0.05).Six months after the surgery,the level of endometrial thickness and the PBAC score in the observation group were significantly lower than those in the control group;the level of hemoglobin was significantly higher than that in the control group;and the differences were statistically significant(P<0.05).One year after the surgery,the recurrence rate in the observation group was 2.50%(1/40),which was lower than 20.00%(8/40)in the control group,and the difference was statistically significant(P<0.05).Further,the incidence of adverse reactions in the observation group was 7.50%(3/40),which was lower than 27.50%(11/40)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Levonorgestrel-releasing intrauterine system after hysteroscopic surgeries has a good effect in the treatment of the patients with endometrial polyps,which can improve the menstrual conditions,inhibit the endometrial hyperplasia,and reduce the incidence of recurrence,anemia and adverse reactions.Moreover,it is superior to oral Dydrogesterone tablets.