子宫内膜息肉的手术治疗及术后复发的预防

目的探讨子宫内膜息肉的宫腔镜手术治疗及术后应用孕激素预防复发的效果。方法选择北京大学深圳医院2001年8月至2007年8月行宫腔镜诊治的子宫内膜息肉86例患者,术后分为激素治疗组和观察组,激素治疗组术后给予安宫黄体酮周期性治疗3个月,观察子宫内膜息肉复发及妊娠情况。结果 86例患者中,宫腔镜检查多发性子宫内膜息肉56例,单发性子宫内膜息肉32例;激素治疗组术后2年,复发率为2.3%,观察组复发率为13.9%,两组比较,差异有统计学意义(P0.05)。32例有生育要求的患者中,术后2年23例自然妊娠,妊娠率为71.9%,但激素治疗组妊娠率(70.6%,12/17)和观察组(73.3%,11/15)比较,差异无统计学意义(P0.05)。结论子宫内膜息肉患者行宫腔镜诊断及治疗效果明确,术后应用孕激素治疗可能有助于预防子宫内膜息肉的复发。

The surgery treatment of endometrial polyps and the prevention of polyps recurrence

Objective To evaluate the clinical effectiveness of hysteroscopy surgery combined with progestin taken for the treatment of endometrial polyps.Methods 86 patients with endometriall polyps who underwent hysteroscopic polypectomy were recruited.According to progestin taken or not,patients were randomly devided into two groups： those treated with progestin for 3 months were in progestin group,others were only under follow up（control group）.All patients were followed up for 2 years.Results Among the 86 patients,56 patients were diagnosed of multiple endometrial polyps,and the other 32 patients were diagnosed of single endometrial polyp.After 2 year＇s follow-up,the recurrent rate was 2.3% in progestin group and 13.9% in control group（P〈0.05）.Among the 32 patients who had fertility requirment,23 were pregnant naturally with the rate of pregancy 71.9%.The rate of pregnancy had no significant difference between the two groups（P〉0.05）.Conclusions Hysteroscopy is a effective method for the diagnosis and treatment of endometrial polyps.Progestin treatment after endometrial polypectomy can decrease the recurrence rate.