不同方法预防多发性子宫内膜息肉电切术后复发的临床效果比较

目的比较不同方法预防多发性子宫内膜息肉电切术后复发的临床效果。方法选择2013年7月至2016年7月于我院行宫腔镜子宫内膜息肉电切术的413例患者为研究对象,根据治疗方法的不同将其分为避孕药组(108例,复方短效口服避孕药),曼月乐组(95例,放置左炔诺孕酮宫内缓释系统),单纯孕激素口服组(110例,单纯孕激素口服)及对照组(100例,不给于任何处理)。比较四组的临床效果。结果术后3、6、12个月,避孕药组、曼月乐组、单纯孕激素口服组的经量增多发生率低于对照组,差异具有统计学意义(P<0.05);术后24个月,曼月乐组的经量增多发生率明显低于避孕药组、单纯孕激素口服组、对照组,差异具有统计学意义(P<0.05)。术后6、12、24个月,避孕药组、曼月乐组、单纯孕激素口服组的阴道不规则出血率及息肉复发率明显低于对照组,差异具有统计学意义(P<0.05)。避孕药组及单纯孕激素口服组的药物漏服率比较,差异无统计学意义(P>0.05)。术后12、24个月,避孕药组、曼月乐组、单纯孕激素口服组的血红蛋白水平均明显高于对照组,差异具有统计学意义(P<0.05)。结论多发子宫内膜息肉术后应用复方短效口服避孕药、左炔诺孕酮宫内缓释系统或单纯口服孕激素均可以明显降低复发率和阴道不规则出血率,但应用左炔诺孕酮宫内缓释系统患者依从性高,术后远期月经量显著减少。

Comparison of the clinical effects of different methods to prevent recurrence of multiple endometrial polyps after electrotomy

Objective To compare the clinical effects of different methods to prevent recurrence of multiple endometrial polyps after electrotomy.Methods From July 2013 to July 2016,413 patients who underwent transcervical resection of polyp in our hospital were selected as the research objects.The patients were divided into contraceptive group(108 cases,compound short-acting oral contraceptives),Mirena group(95 cases,placed levonorgestrel-releasing intrauterine system),simple oral progesterone group(110 cases,simple oral progesterone)and control group(100 cases,without any treatment)according to the different treatment method.The clinical effects of the four groups were compared.Results At 3,6 and 12 months after surgery,the incidence of increased menstrual volume in the contraceptive group,the Mirena group and the simple oral progesterone group were lower than those in the control group,and the differences were statistically significant(P<0.05);at 24 months after surgery,the incidence of increased menstrual volume in the Mirena group were significantly lower than that in the contraceptive group,the simple oral progesterone group and the control group,and the differences were statistically significant(P<0.05).At 6,12 and 24 months after surgery,the irregular vaginal bleeding rate and polyp recurrence rate in the contraceptive group,the Mirena group and the simple oral progesterone group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the rate of drug leakage between the contraceptive group and the simple oral progesterone group(P>0.05).At 12 and 24 months after surgery,the hemoglobin level in the contraceptive group,the Mirena group and the simple oral progesterone group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Application of compound short-acting oral contraceptives,levonorgestrel-releasing intrauterine system or simple oral progesterone after surgery for multiple endometrial polyps can significantly reduce the rates of recurrence and irregular vaginal bleeding.However,patients using levonorgestrel-releasing intrauterine system have a high compliance,and the long-term postoperative menstrual volume significantly reduces.