曼月樂(lè)預(yù)防宮腔鏡下子宮內(nèi)膜息肉切除術(shù)后息肉復(fù)發(fā)的療效觀察.pdf

1、左炔諾孕酮宮內(nèi)緩釋系統(tǒng)預(yù)防宮腔鏡下子宮內(nèi)膜息肉切除術(shù)后息肉復(fù)發(fā)的療效觀察中文摘要目的：觀察宮腔鏡下子宮內(nèi)膜息肉電切術(shù)(transcervicalresectionofendometrialpolyps，TCRP)后放置左炔諾孕酮宮內(nèi)緩釋系統(tǒng)(1evonorgestrelreleasingintrauterinesystem，LNG—IUS，商品名Mirena)預(yù)防子宮內(nèi)膜息肉(endometrialpolyps)復(fù)發(fā)的療效。方法：收集本

2、院近期經(jīng)宮腔鏡診治的子宮內(nèi)膜息肉的病例315例，其中單純性子宮內(nèi)膜息肉198例，子宮內(nèi)膜息肉合并子宮腺肌病38例，子宮內(nèi)膜息肉合并子宮肌瘤40例，乳腺癌術(shù)后口服他莫昔芬合并子宮內(nèi)膜息肉39例，行子宮內(nèi)膜息肉電切術(shù)后，單純性子宮內(nèi)膜息肉(A組)中隨機(jī)分為三組，研究組①(TCRP曼月樂(lè))65例，宮腔鏡下內(nèi)膜息肉切除術(shù)后放置左炔諾孕酮宮內(nèi)緩釋系統(tǒng)；研究組②(TCRP甲羥孕酮)68例，宮腔鏡下內(nèi)膜息肉切除術(shù)后于術(shù)后第一次月經(jīng)的第15天口服醋酸甲

3、羥孕酮10mg／d，連服10天，重復(fù)上述方法3月；對(duì)照組(TCRP)65例，宮腔鏡下內(nèi)膜息肉切除術(shù)后無(wú)任何治療措施。比較3組患者12個(gè)月子宮內(nèi)膜息肉復(fù)發(fā)率。其余患者(即合并其它疾病者為B組)117例，行宮腔鏡下子宮內(nèi)膜息肉切除術(shù)后，隨機(jī)分為二組，研究組(TCRP曼月樂(lè))59例，宮腔鏡下內(nèi)膜息肉切除術(shù)后放置左炔諾孕酮宮內(nèi)緩釋系統(tǒng)；對(duì)照組58例，宮腔鏡下內(nèi)膜息肉切除術(shù)后無(wú)任何治療措施。比較2組患者12個(gè)月子宮內(nèi)膜息肉復(fù)發(fā)率。結(jié)果：A組單純性

4、子宮內(nèi)膜息肉組三組(即研究組①、研究組②、對(duì)照組)復(fù)發(fā)率分別為0％，645％，2462％，研究組①(TCRP曼月樂(lè))、研究組②(TCRP甲羥孕酮)分別與對(duì)照組比較，子宮內(nèi)膜息肉復(fù)發(fā)率均明顯降低(P005)，差異有統(tǒng)計(jì)學(xué)意義；研究組①(TCRP曼月樂(lè))子宮內(nèi)膜息肉復(fù)發(fā)率明顯低于研究組②(TCRPI尹羥孕酮)(P005)，差異有統(tǒng)計(jì)學(xué)意義。B組中曼月樂(lè)組復(fù)發(fā)率為17％，對(duì)照組復(fù)發(fā)率為2585％，兩組比較差異有統(tǒng)計(jì)學(xué)意義(P005)。結(jié)論：宮

5、腔鏡下子宮內(nèi)膜息肉切除術(shù)聯(lián)合左炔諾孕酮宮內(nèi)緩釋系統(tǒng)能有效預(yù)防子宮內(nèi)ClinicalobservationoflevonorgestrelreleasingintrauterinesystemforpreventingrecurrenceofendometrialpolypsaftertranscervicalresectionofendometrialpolypsunderhysteroscopyAbstractObjective：To

6、observetheefficiencyoflevonorgestrel—releasingintrauterinesystem(LNG—IUS；Tradename：Mirena)forpreventingrecurrenceofendometrialpolypsaftertranscervicalresectionofendometrialpolyps(TCRP)underhysteroscopyMethods：Therewere31

7、5caseswithendometrialpolypsunderhysteroscopyinourhospitalrecentlyincluding198caseswithsimpleendometrialpolyps，38caseswithendometrialpolypscombinedadenomyosis，40caseswithendometrialpolypscombinedmyomaofuterus，and39casestr

8、eatedwithorallyadministrationofTamoxifenafterbreastcancersurgerybutwithendometrialpolypsAfterTCRPthecaseswithsimpleendometrialpolyps(groupA)wererandomlysubdividedinto3groups，group①(TCRPMirena)of65casesweretreatedwithLNG—

9、IUSafterTCRPunderhysteroscopy；group②(TCRPmedroxyprogesterone)of68casesweretreatedwithorallyadministrationofmedroxyprogesteroneatthe15mdayofthefirstmensesafterTCRPunderhysteroscopy10mgperdaycontinuouslyfor10daysTheaboveme

10、thodswererepeatedfor3monthsTherewere65casesincontrolgroup(TCRP)withoutanyothertreatmentafterTCRPunderhysteroscopyTherecurrencerateofendometrialpolypsWascomparedamong3groupswithin12monthsOther117cases(combinedwithotherdis

11、easesregardedasgroupB)weretreatedwithTCRPunderhysteroscopyandrandomlydividedinto2groupsThestudygroup(TCRPMirena)of59casesweretreatedwithLNGIUSafterTCRPunderhysteroscopy；controlgroupof58caseswerewithoutanyothertreatmentaf

12、terTCRPunderhysteroscopyTherecurrencerateofendometrialpolypswascomparedbetween2groupswithin12monthsResults：Therecurrenceratesof3subgroups(studygroup①，studygroup②andcontrolgroup)ingroupAwithsimpleendometrialpolypswere0％，6