宫腔镜下子宫内膜息肉切除术后应用不同类型药物预防复发的疗效分析  

Effective observation on different kinds of drug for preventing recurrence after hysteroscopic resection of endometrial polyp

作　　者：滑玮[1] 邹伟[1] 刘朵朵[1] 高燕[1] 陈必良[1] 

机构地区：[1]第四军医大学西京医院妇产科,陕西西安710032

出　　处：《现代医药卫生》2013年第5期672-674,共3页Journal of Modern Medicine & Health

摘　　要：目的对比宫腔镜下子宫内膜息肉切除术后应用不同类型药物预防息肉复发的疗效和安全性。方法回顾性分析516例子宫内膜息肉患者临床及随访资料,所有患者均在宫腔镜下切除息肉,并于术后使用不同类型药物治疗,将患者随机分为四组,A组为短效避孕药治疗组,B组为孕激素治疗组,C组为孕三烯酮治疗组,D组为无药物治疗的对照组。药物治疗疗程为3个月,分别于术后6、12、24个月进行随访,对比不同药物在预防复发方面的疗效。结果所有患者手术均顺利完成,术后经病理检查确诊为子宫内膜息肉。药物治疗后各组患者的月经模式均有所改善,月经量明显减少,血红蛋白水平显著增加。术后6个月,治疗组之间的息肉复发率无明显差异;术后12、24个月,C组复发率明显低于A、B组;在不同的随访时间,治疗组复发率均显著低于对照组。整个治疗和随访过程中无严重不良反应发生。结论宫腔镜下切除子宫内膜息肉后,选择恰当的药物治疗,可显著控制息肉复发,短效避孕药和孕三烯酮的疗效优于孕激素,其中短效避孕药的接受性和依从性优于孕三烯酮,而孕三烯酮对远期复发的预防效果优于其他药物。Objective To compare the curative effects and safeties of different kinds of drug for preventing recurrence after hysteroscopic resection of endometrial polyp. Methods The clinical and follow-up data of 516 cases of endometrial polyp were retrospectively analyzed.The patients all received hysteroscopic resection of endometrial polyp and used different kinds of drug. The patients were divided into four groups randomiy, A for oral contraception （OC）, B for progesterone, C for gestrinone, D as control without taking drug,for 3-month medication therapy. The therapeutic effects of different medicines on preventing re- currence were compared during 6,12,24 months follow up. Results The operation was successfully completed for all the pa- tients. The postoperative pathological result was endometrial polyp. After medication, the menstrual modes of almost all the pa- tients were changed, the menstrual volumes were reduced significantly and the hemoglobin level was increased significantly. There were no significant difference in the polyp recurrence rate in postoperative 6 months among the three groups, which in postopera- tive 12,24 months in the group C was significantly lower than that in the group A and B ,and which at different follow up time in the treatment group was obviously lower than that in the control group. During the follow-up period, no obvious adverse reactions occurred. Conclusion Hysteroscopic resection of polyp and postoperative application of proper medication can apparently con- trol the recurrence of endometrial polyp. The effects of OC and gestrinone are better than progesterone. The receptivity and com- pliance of OC is better than gestrinone, while the effect of preventing recurrence of gestrinone is superior to other medicines.

关 键 词：息肉 外科学 子宫内膜肿瘤 外科学 宫腔镜 避孕药 口服 治疗应用 孕三烯酮 治疗应用 孕激素类 治疗应用 复发 预防和控制 ’ 

分 类 号：R737.33[医药卫生—肿瘤]