宫腔镜电切术联合LNG-IUS治疗子宫内膜不典型增生的临床分析  

Clinical analysis of hysteroscopic lesion electrotomy combined with LNG-IUS in the treatment of endometrial atypical hyperplasia

作　　者：张晶 沈维维[1] 朱淼华[1] 王加颖 王婷婷 周晓明[1] ZHANG Jing;SHEN Weiwei;ZHU Miaohua;WANG Jiaying;WANG Tingting;ZHOU Xiaoming(Department of Obstetrics and Gynecology,Affiliated Hospital of Ningbo University School of Medicine,Zhejiang Ningbo 315040,China)

机构地区：[1]宁波大学医学院附属医院妇产科,浙江宁波315040

出　　处：《中国妇幼健康研究》2022年第2期95-99,共5页Chinese Journal of Woman and Child Health Research

基　　金：浙江省自然科学基金(LY18H040009);宁波市自然科学基金(2017A160166)。

摘　　要：目的研究宫腔镜电切术联合左诀诺孕酮宫内缓释系统(LNG-IUS)治疗子宫内膜不典型增生的临床疗效及安全性。方法选取2017年4月至2020年4月期间收治的80例子宫内膜不典型增生患者为研究对象,对其资料进行回顾性研究,并依据治疗方案将其分为研究组与对照组,每组40例。研究组在LNG-IUS干预基础上联合宫腔镜电切术治疗,对照组给予常规孕激素等治疗,比较两组临床疗效、不良反应、雌激素水平变化、月经量情况及妊娠结局。结果研究组与对照组患者临床疗效的差异无统计学意义(χ^(2)值分别为0.556、1.013,P>0.05);研究组患者并发症及不良反应总发生率明显低于对照组,差异有统计学意义(χ^(2)值分别为7.671、9.006,P<0.05);治疗后,研究组患者的血清雌二醇、促黄体生成素、促卵泡生成素水平,以及月经失血图评分均较对照组下降明显,差异有统计学意义(t值分别为5.356、4.049、5.864、3.868,P<0.05);研究组的不良妊娠结局发生率明显低于对照组(χ^(2)值分别为6.275、14.066,P<0.05)。结论LNG-IUS干预基础上联合宫腔镜电切术治疗子宫内膜不典型增生的不良反应与并发症较少,能够有效调节雌激素分泌,改善妊娠结局,可作为优质治疗方案考虑在临床推广应用。Objective To study the clinical efficacy and safety of hysteroscopic lesion electrotomy combined with levonorgestrel releasing intrauterine system(LNG-IUS)in the treatment of endometrial atypical hyperplasia.Methods 80 patients with endometrial atypical hyperplasia admitted from April 2017 to April 2020 were selected as the research objects.The clinical data of all patients were reviewed and divided into a study group and a control group according to the treatment plan,with 40 cases in each group.The patients in the study group were treated with hysteroscopic lesion electrotomy on the basis of LNG-IUS intervention,and the patients in the control group were given conventional progesterone and other treatments.The clinical efficacy,adverse reactions,changes in estrogen levels,menstrual flow and pregnancy outcomes were compared between the two groups.Results There was no statistically significant difference in clinical efficacy between the study group and the control group(χ^(2) values were 0.556 and 1.013,respectively,P>0.05).The total incidence of complications and adverse reactions in the study group were significantly lower than those in the control group,and the differences were statistically significant(χ^(2) values were 7.671 and 9.006,respectively,P<0.05).After treatment,the levels of serum estradiol,luteinizing hormone,follicle stimulating hormone,and pictorial blood loss assessment chart scores of the study group were significantly lower than those of the control group,and the differences were statistically significant(t values were 5.356,4.049,5.864 and 3.868,respectively,P<0.05);The incidence of adverse pregnancy outcomes in the study group was significantly lower than that in the control group(χ^(2) values were 6.275 and 14.066,respectively,P<0.05).Conclusion LNG-IUS intervention combined with hysteroscopic lesion electrotomy in the treatment of endometrial atypical hyperplasia has fewer adverse reactions and complications,and can effectively regulate estrogen secretion and improve pregnancy outcomes

关 键 词：宫腔镜电切术 左诀诺孕酮 子宫内膜不典型增生 不良反应 并发症 

分 类 号：R737.33[医药卫生—肿瘤]