Norplant皮下埋植后宫腔镜下所见及内膜组织学变化  

HYSTEROSCOPIC APPEARANCE AND HISTOLOGIC CHANGES OF THE ENDOMETRIUM AFTER NORPLANT IMPLANTATION

作　　者：余妙真[1] 陈学煌[1] 梁玉萍[1] 李海刚[1] 

机构地区：[1]中山医科大学孙逸仙纪念医院

出　　处：《中山医科大学学报》1998年第1期64-66,共3页Academic Journal of Sun Yat-sen University of Medical Sciences

基　　金：广东省计划生育委员会基金

摘　　要：目的：探讨ＬＮＧ（左旋１８甲基炔诺酮）对子宫内膜的影响。方法：应用宫腔镜检查技术，观察了５５例不同年度的Ｎｏｒｐｌａｎｔ埋植者及其埋植后不同月经类型妇女的子宫内膜。结果：发现埋植者子宫内膜于宫腔镜下呈现３种基本类型的改变，此改变与埋植时间的长短无关。而４８例送验的内膜组织中有３７５％可见如下病理学特征：①呈腺上皮发育及再生修复障碍或迟缓；②组织变薄；③腺体分泌不同步；④小血管扩张、充血、出血；⑤间质中有炎症细胞浸润。有２９１７％的内膜间质呈轻～中度蜕膜样变。有１６６７％内膜呈明显萎缩型改变。结论：导致上述一系列改变的主要原因是由于埋植者体内的雌激素水平低下所致，对埋植后引起月经异常的患者给予外源性雌激素类药物治疗是十分必要的。Objective:To assess the effect of LNG (levonorgestrel) implicating the endometrium.Methods:Fiftyfive Norplant users certain years after insertion with different menstrual patterns were recruited for hysteroscopy, during which endometrium biopsy were taken.Results:The hysteroscopic appearance of the endometrium were classified into three types, of which had no relationship with the time period after insertion. The following features were found: 375% of the 48 satisfied endometrial histology showed: ①impairment or retardation of the adenoepithelium regeneration and development, ②thinning of the tissue, ③desynchronization of the glandular secretion, ④dilation, congestion and/or hemorrhage of the small vessel, ⑤inflammatory infiltration of the endometrial mesenchyma. Mild to moderate decidual change of the endometrial mesenchyma was observed in 29.17% of the cases. In 16.67% of the cases obvious endometrial atrophy was observed.Conclusions:The changes mentioned were thought to be caused by the lowered estrogen concentration. It was suggested that exogenous estrogen was very important for treating menstrual disorders after Norplant implantation.

关 键 词：左炔诺孕酮 子宫内膜 宫腔镜 皮下埋植 月经异常 

分 类 号：R979.21[医药卫生—药品] R711.510.2[医药卫生—药学]