宫腔镜子宫内膜电切除术联合左炔诺孕酮宫内节育系统治疗围绝经期AUB患者对子宫内膜厚度、性激素水平及AUB复发率的影响  

Effects of Hysteroscopic Electroendometrial Resection Combined with Levonorgestrel Intrauterine Birth Control System on Endometrial Thickness,Sex Hormone Levels and AUB Recurrence Rate in Perimenopausal AUB Patients

作　　者：田兴芳 杨自萍 TIAN Xingfang;YANG Ziping(Department of Gynaecology and Obstetrics,Anting Hospital in Shanghai's Jiading District,Shanghai 201805)

机构地区：[1]上海市嘉定区安亭医院妇产科,上海201805

出　　处：《医学临床研究》2024年第4期492-495,499,共5页Journal of Clinical Research

摘　　要：【目的】探讨宫腔镜子宫内膜电切除术联合左炔诺孕酮宫内节育系统治疗围绝经期异常子宫出血(AUB)患者对子宫内膜厚度、性激素水平及AUB复发率的影响。【方法】选取2020年2月至2023年3月本院收治的90例围绝经期AUB患者,采用信封法分为观察组(n=46)和对照组(n=44)。对照组采用宫腔镜子宫内膜电切除术治疗,观察组采用左炔诺孕酮宫内节育系统联合宫腔镜子宫内膜电切除术治疗,比较两组治疗效果、月经失血图(PBAC)评分、子宫内膜厚度、血红蛋白(Hb)、性激素水平、并发症发生率、月经情况及AUB复发情况。【结果】观察组治疗总有效率为95.65%,显著高于对照组的81.82%(P<0.05)。治疗后,两组PBAC评分及子宫内膜厚度均降低,且观察组低于对照组(P<0.05);治疗后,两组Hb升高,且观察组高于对照组(P<0.05)。治疗后,两组雌二醇(E 2)、孕酮(P)、卵泡刺激素(FSH)以及黄体生成素(LH)均降低,且观察组低于对照组(P<0.05)。治疗6个月后,两组感染、子宫腺肌瘤及输卵管绝育综合征等并发症发生率比较,差异无统计学意义(P>0.05),观察组宫腔粘连发生率低于对照组(P<0.05)。两组闭经、经量正常率比较,差异无统计学意义(P>0.05);观察组经量减少率高于对照组(P<0.05)。观察组AUB复发率低于对照组(P<0.05)。【结论】宫腔镜子宫内膜电切除术联合左炔诺孕酮宫内节育系统治疗围绝经期AUB患者,治疗效果显著,可降低患者出血量、性激素水平及子宫内膜厚度,且安全性良好、AUB复发率低。【Objective】To investigate the effects of hysteroscopic electroendometrial resection combined with levonorgestrel intrauterine birth control system on endometrial thickness,sex hormone levels and recurrence rate in patients with perimenopausal abnormal uterine bleeding(AUB).【Methods】A total of 90 patients with perimenopausal AUB admitted to our hospital from February 2020 to March 2023 were selected and divided into the observation group(n=46)and the control group(n=44)by random envelope method.The control group was treated with hysteroscopic electrohysterectomy,while the observation group was treated with levonorgestrel intrauterine birth control system combined with hysteroscopic electrohysterectomy.The therapeutic effect,menstrual blood loss chart(PBAC)score,endometrial thickness,hemoglobin(Hb),sex hormone level,complications,menstrual status,and recurrence of the two groups were compared.【Results】The total effective rate of the observation group was 95.65%,which was significantly higher than that of the control group(81.82%,P<0.05).After treatment,the PBAC score and endometrial thickness of both groups decreased with the observation group showing lower than the control group(P<0.05).After treatment,Hb increased in both groups,and Hb in the observation group was higher than that in the control group(P<0.05).After treatment,estradiol(E 2),progesterone(P),follicle stimulating hormone(FSH)and luteinizing hormone(LH)decreased in both groups,while E 2,P,FSH and LH levels in the observation group were lower than those in the control group(P<0.05).After 6 months of treatment,there was no significant difference in the incidence of infection,uterine adenomyosis and tubal sterilization syndrome between the two groups(P>0.05).The incidence of uterine adhesion in the observation group was lower than that in the control group(P<0.05).There was no significant difference in amenorrhea and normal menses between the two groups(P>0.05).The decrease rate of menstrual volume in observation group was higher than that in

关 键 词：子宫出血/治疗 左炔诺孕酮/治疗应用 电外科手术 宫腔镜检查 围绝经期 子宫内膜 

分 类 号：R711.52[医药卫生—妇产科学]