【摘要】 目的探讨宫腔镜子宫内膜息肉切除术(TRCP)不同术式及宫腔镜联合屈螺酮炔雌醇(DE)治疗子宫内膜息肉(EP)的效果。方法将130例EP患者随机分为3组。A组:46例,采取TRCP+子宫内膜电凝术+DE;B组:42例,采取TRCP+子宫内膜电凝术;C组:42例,采取TRCP+子宫内膜电切除术。对比3组月经情况、并发症、EP复发及妊娠情况。结果治疗后A组月经量明显少于B组、C组,差异有统计学意义(皆P<0.01),而B组月经量明显少于C组,差异有统计学意义(P<0.01)。治疗后A组月经周期正常的比例明显高于B组、C组,差异有统计学意义(皆P<0.01),而B组、C组间月经周期正常的比例相接近,两组比较差异无统计学意义(P>0.05)。治疗后A组子宫内膜厚度明显小于B组、C组,差异有统计学意义(皆P<0.01),而B组子宫内膜厚度明显小于C组,差异有统计学意义(P<0.01)。1年随访期间三组间妊娠率差异无统计学意义(P>0.05)。半年、1年随访期间A组EP复发率明显少于B组、C组,差异有统计学意义(皆P<0.01),而B组EP复发率明显少于C组,差异有统计学意义(P<0.01)。治疗后3组间各种不良反应比较差异无统计学意义(P>0.05)。结论 TCRP联合DE治疗EP,可减少月经过多症状、缓解月经不调、抑制子宫内膜增生,减少EP复发,且并发症较少,安全性比较高,综合疗效明显优于单纯TCRP。更多还原

【Abstract】 Objective To explore the effects of different transcervical resection methods of polyp and hysteroscopy combined with drospirenone and ethinylestradiol tablets in treatment of endometrial polyps. Methods A total of 130 patients with endometrial polyps were randomly divided into three groups; 46 patients in group A received transcervical resection of polyp,endometrial electric coagulation,and drospirenone and ethinylestradiol tablets; 42 patients in group B received transcervical resection of polyp and endometrial electric coagulation; 42 patients in group C received transcervical resection of polyp and endometrial electric resection. The menstruation,complications,recurrence of endometrial polyps,and pregnancy rates in the three groups were compared. Results Menstrual quantity after treatment in group A was statistically significantly less than those in group B and group C( P < 0. 01),menstrual quantity after treatment in group B was statistically significantly less than that in group C( P < 0. 01). After treatment,the proportion of patients with normal menstruation in group A was statistically significantly higher than those in group B and group C( P < 0. 01),but there was no statistically significant difference between group B and group C( P > 0. 05). Endometrial thickness after treatment in group A was thinner than those in group B and group C( P <0. 01),endometrial thickness after treatment in group B was thinner than that in group C( P < 0. 01). There was no statistically significant difference in the pregnancy rate among the three groups within one year( P > 0. 05). The recurrence rates of endometrial polyps in group A within half a year and one year were statistically significantly lower than those in group B and group C( P < 0. 01),the recurrence rate of endometrial polyps in group B was statistically significantly lower than that in group C( P < 0. 01); after treatment,there was no statistically significant difference in the incidence rate of various complications among the three groups( P > 0. 05). Conclusion Transcervical resection of polyp combined with drospirenone and ethinylestradiol tablets can reduce the symptoms of menorrhagia,alleviate menoxenia,inhibit endometrial hyperplasia,reduce the recurrence of endometrial polyps,which has the advantages of less complications and higher security,the comprehensive curative effect is superior to pure transcervical resection of polyp.更多还原