宫腔镜手术配合术后孕激素治疗子宫内膜息肉患者的效果及对月经状况和复发率的影响分析  

Analysis of the Effect of Hysteroscopic Surgery Combined with Postoperative Progesterone in the Treatment of Endometrial Polyps and Its Effect on Menstrual Status and Recurrence Rate

作　　者：蒲雯婕[1] 孙薇 康筱珊[1] 马娟文[1] PU Wenjie;SUN Wei;KANG Xiaoshan;MA Juanwen(Department of Gynecology,Lanzhou Maternal and Child Health Hospital,Lanzhou 730030,Gansu,China)

机构地区：[1]兰州市妇幼保健院妇科,甘肃兰州730030

出　　处：《中外医疗》2024年第21期25-29,共5页China & Foreign Medical Treatment

基　　金：子宫内膜息肉对女性生育力的影响及相关治疗研究(2022-5-159)。

摘　　要：目的分析对于用宫腔镜手术治疗的子宫内膜息肉患者,配合术后孕激素治疗的效果及对月经状况和复发率的影响。方法方便选择2022年1月—2023年1月兰州市妇幼保健院收治的96例子宫内膜息肉患者为研究对象,并按照治疗方法的不同分为两组,每组48例。两组均接受宫腔镜手术治疗,在此基础上,对照组采用醋酸甲羟孕酮分散片治疗,观察组采用地屈孕酮治疗。比较两组治疗前后的月经量、月经期、子宫内膜厚度及雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)表达评分,复发率、并发症发生率、临床疗效。结果治疗后3个月和6个月,观察组月经量比对照组少,且月经期比对照组短,差异有统计学意义(P均<0.05)。治疗后3个月和6个月,观察组子宫内膜厚度比对照组小,差异有统计学意义(P均<0.05)。治疗后,观察组ER表达评分低于对照组,PR表达评分高于对照组,差异有统计学意义(P均<0.05)。观察组复发率为0,低于对照组的10.00%(4/40),差异有统计学意义(χ^(2)=4.824,P<0.05)。两组的并发症发生率比较,差异无统计学意义(P>0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论对于子宫内膜息肉患者,在开展宫腔镜手术治疗的基础上采用孕激素类药物(地屈孕酮)加强治疗,能够调节ER、PR水平,改善月经状况和子宫内膜厚度,降低复发风险,且安全性较高,增强临床治疗效果。Objective To analyze the effect of hysteroscopic surgery combined with postoperative progesterone in the treatment of endometrial polyps and its effect on menstrual status and recurrence rate.Methods A total of 96 patients with endometrial polyps admitted to Lanzhou Maternal and Child Health Hospital from January 2022 to January 2023 were conveniently selected as the research objects and divided into two groups according to the different treatment method,with 48 cases in each group.Both groups received hysteroscopic surgery.On this basis,the control group was treated with medroxyprogesterone acetate dispersible tablets,and the observation group was treated with dydrogesterone.The menstrual volume,menstrual period,endometrial thickness,estrogen receptor(ER),progesterone receptor(PR)expression score,recurrence rate,complication rate and clinical efficacy were compared between the two groups before and after treatment.Results At 3 months and 6 months after treatment,the menstrual volume in the observation group was less than that in the control group,and the menstrual period was shorter than that in the control group,and the differences were statistically significant(all P<0.05).At 3 months and 6 months after treatment,the endometrial thickness of the observation group were smaller than those of the control group,and the differences were statistically significant(both P<0.05).After treatment,the ER expression score of the observation group was lower than that of the control group,and the PR expression score was higher than that of the control group,the differences were statistically significant(both P<0.05).The recurrence rate of the observation group was 0,which was lower than 10.00%(4/40)of the control group,and the difference was statistically significant(χ^(2)=4.824,P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).The total effective rate of treatment in the observation group was higher than that in the control group,and the difference wa

关 键 词：子宫内膜息肉 宫腔镜手术 孕激素 月经状况 复发率 

分 类 号：R713.4[医药卫生—妇产科学]