子宫内膜息肉给予宫腔镜息肉电切术辅以左炔诺孕酮宫内缓释系统的疗效分析  

Efficacy of Hysteroscopic Electropolypectomy Combined with Levonorgestrel Intrauterine Sustained Release System for Endometrial Polyps

作　　者：张丽艳 孙爽 ZHANG Liyan;SUN Shuang(Department of Obstetrics and Gynecology Diagnosis and Treatment Center,the Affiliated Hospital of Changchun Uni-versity of Chinese Medicine,Changchun,Jilin Province,130021 China)

机构地区：[1]长春中医药大学附属医院妇产诊疗中心,吉林长春130021

出　　处：《中外医疗》2023年第32期59-62,共4页China & Foreign Medical Treatment

摘　　要：目的 观察在子宫内膜息肉的治疗当中在给予宫腔镜息肉电切术之后辅助使用左炔诺孕酮宫内缓释系统治的效果。方法 便利选取2022年1月—2023年2月长春中医药大学附属医院收治的98例子宫内膜息肉患者。按随机数表法分为两组,各49例。对照组采用宫腔镜息肉电切术治疗,观察组在对照组基础上辅以左炔诺孕酮宫内缓释系统。对比治疗后腺上皮及间质雌激素受体、腺上皮及间质孕激素受体、血清指标、复发率等。结果 观察组术后1个月月经量更少、血红蛋白水平上升,且观察组术后3及6个月其子宫内膜厚度及月经量少于对照组,血红蛋白水平高于对照组,差异有统计学意义(P<0.05);治疗后观察组腺上皮及间质雌激素受体、腺上皮及间质孕激素受体、血清指标水平均低于对照组,差异有统计学意义(P<0.05);观察组的复发率为4.08%,低于对照组的16.33%,差异有统计学意义(χ~2=4.455,P<0.05)。结论 在子宫内膜息肉的患者的宫腔镜息肉电切术之后辅以左炔诺孕酮宫内缓释系统治疗,能够使原本较厚的子宫内膜变薄,并减少原本过多的月经量,恢复血红蛋白及血清糖类抗原125、高敏C反应蛋白、血管内皮生长因子水平,调节雌激素及孕激素受体表达平衡,降低复发率,且具有良好的治疗安全性。Objective To observe the effect of levonorgestrel intrauterine sustained release system after hysteroscopic electropolypectomy in the treatment of endometrial polyps.Methods A total of 98 patients with endometrial polyps admitted to the Affiliated Hospital of Changchun University of Traditional Chinese Medicine from January 2022 to February 2023 were conveniently selected.According to the random number table method,they were divided into two groups,49 cases in each group.The control group was treated with hysteroscopic polyp resection,and the observation group was supplemented with levonorgestrel intrauterine sustained-release system on the basis of the control group.The glandular epithelial and stromal estrogen receptors,glandular epithelial and stromal progesterone receptors,serum indexes,and recurrence rate were compared after treatment.Results The menstrual volume of the observation group was lower and the hemoglobin level was higher 1 month after operation,and the endometrial thickness and menstrual volume of the observation group were less than those of the control group 3 and 6 months after operation,and the hemoglobin level were higher than that of the control group,and the differences were statistically significant(P<0.05) after treatment,the levels of estrogen receptor in glandular epithelium and stroma,progesterone receptor in glandular epithelium and stroma,and serum indexes in the observation were all lower than those in the control group,and the differences were statistically significant(P<0.05),the recurrence rate of the observation group was 4.08%,which was lower than 16.33% of the control group,and the difference was statistically significant(χ~2=4.455,P<0.05).Conclusion Treatment with levonorgestrel intrauterine sustained release system after hysteroscopic electropolypectomy in patients with endometrial polyps can thin the originally thick endometrial lining.It can reduce the original excessive menstrual volume,restore the levels of hemoglobin and serum CA125,hs-CRP,VEGF,regulate the balance of

关 键 词：子宫内膜息肉 宫腔镜 息肉电切术 左炔诺孕酮宫内缓释系统 子宫内膜厚度 月经量 

分 类 号：R713[医药卫生—妇产科学]