左炔诺孕酮宫内缓释节育系统抑制复发性子宫内膜息肉的远期临床观察  

Long-term Clinical Observation on Levonorgestrel Releasing Intrauterine System Suppression of Recurrent Endometrial Polyps

作　　者：付熙[1] 易金玲[2] 丁岩[1] 

机构地区：[1]新疆医科大学第一附属医院妇科,新疆乌鲁木齐830054 [2]新疆医科大学第五附属医院妇科,新疆乌鲁木齐830011

出　　处：《继续医学教育》2015年第11期120-122,共3页Continuing Medical Education

基　　金：新疆维吾尔自治区自然科学基金资助(2015211C043)

摘　　要：目的：通过比较左炔诺孕酮宫内缓释节育系统（LNG-IUS，曼月乐）与促性腺激素释放激素的激动剂（GnRH-a）对复发性子宫内膜息肉患者术后复发率的差异，为临床选择术后治疗方式提供依据。方法将复发性子宫内膜息肉术后患者按是接受放置曼月乐还是使用GnRH-a药物治疗分两组，放置曼月乐环为病例组，注射GnRH-a为对照组，每组各30例，曼月乐组患者于术后即放置或下次月经干净后3～5 d放置曼月乐宫内节育系统；GnRH-a药物组患者于术后第2天注射达菲林3.75 mg，28天重复一次，连续治疗2～3个周期。结果分别于宫腔镜下子宫内膜电切术后第1、2、3年随访，1年复发率曼月乐组为0（0/30），GnRH-a组为3.3％（1/30），2年复发率曼月乐组为0（0/30），GnRH-a组为6.6％（2/30），3年复发率曼月乐组为3.3％（1/30），GnRH-a组为13.2％（4/30），曼月乐组与GnRH-a组比较差异均有统计学意义（P＜0.05）。结论复发性子宫内膜息肉患者宫腔镜术后曼月乐组的复发率低于GnRH-a组，故曼月乐环抑制复发性子宫内膜息肉复发的效果优于GnRH-a组，曼月乐环抑制复发性子宫内膜息肉复发的远期临床疗效较好。Objective To compare the differences between levonorgestrel releasing intraute system（LNG-IUS, Mirena） with Gonadotropin releasing hormone agonist （GnRH-a） for recurrence rate in patients with recurrence of endometrial polyps afer hysteroscopic polypectomy. Provide the basis for the select postoperative treatment in clinical work. Methods The recurrent endometrial polyp patients are divided by placing Mirena or the use of GnRH-a therapy in two groups, placed Mirena ring for the case group, injected GnRH-a for the control group, 30 cases in each group, the patients in mirena group place Mirena intrauterine system after surgery or 3~5 days after the next menstrual clean, the patients of GnRH-a group inject Diphereline 3.75 mg in the next day afer opeation, 28-day repeated once, last for 2 to 3 cycles of treatment. Results Follow-up is performed Respectively after 1, 2, 3 years of hysteroscopic polypectomy, 1-year recurrence rate of Mirena group was 0 （0/30）, GnRH-a group was 3.3% （1/30）, 2-year recurrence rate Mirena group was 0 （0/30）, GnRH-a group was 6.6% （2/30）, 3-year recurrence rate of Mirena group was 3.3% （1 / 30）, GnRH-a group was 13.2% （4/30）, the differences between Mirena group and GnRH-a group are statistically signiifcant （P〈0.05）.Conclusion The recurrence rate of Mirena group is lower than GnRH-a group in patients with recurrent endometrial polyps after hysteroscopic polypectomy, so Mirena ring group is better than GnRH-a group in suppress recurrent of endometrial polyps ,the long-term clinical efifcacy of Mirena ring is better in the suppression of recurrent endometrial polyps.

关 键 词：子宫内膜息肉 左炔诺孕酮宫内缓释节育系统 促性腺激素释放激素的激动剂 复发 宫腔镜 

分 类 号：R711[医药卫生—妇产科学]