【摘要】 目的：探究宫腔镜下电切术(TCRP)联合促性腺激素类药物亮丙瑞林对子宫内膜息肉(EP)患者复发率及子宫内膜厚度的影响。方法：本研究针对我院收治的EP患者采取回顾性研究分析，收集2018年7月～2020年7月符合标准的临床病例资料共98例，按照不同治疗方式分为观察组(n=59，TCRP联合亮丙瑞林治疗)和对照组(n=39，单纯TCRP治疗)。所有患者术前均用米索前列醇片进行宫颈预处理，术后6个月内定期复查，每3月复查一次，比较两组患者术前及术后3月、6月血清促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平、子宫内膜厚度、血管内皮生长因子(VEGF)及转化生长因子(TGF-β1)相对表达量，比较术后6月、1年子宫内膜息肉复发率。结果：观察组术后3月、6月FSH、LH、E2水平[(3.85±0.98)IU/L、(3.62±0.86)IU/L、(70.82±10.26)pg/mL]、[(4.35±1.06)IU/L、(3.98±0.67)IU/L、(73.15±11.59)pg/mL]均低于比对照组[(5.52±1.18)IU/L、(4.98±1.27)IU/L、(89.25±11.35)pg/mL]、[(5.37±1.21)IU/L、(4.72±1.15)IU/L、(85.79±11.16)pg/mL]；观察组术后6月、1年EP新增复发例数[(1/59，1.69%)、(3/59，5.08%)]均低于对照组[(5/39，12.82%)、(8/39，20.51%)]，观察组总复发率(4/59，6.77%)明显低于对照组(13/39，33.33%)；两组患者术后3月、6月的子宫内膜厚度均明显低于术前，观察组术后3月、6月子宫内膜厚度[(0.33±0.07)cm、(0.42±0.08)cm]均明显低于对照组[(0.52±0.11)cm、(0.79±0.15)cm]，观察组术后3月、6月VEGF蛋白相对表达量[(93.14±15.32)、(100.59±18.93)]均明显少于对照组[(105.06±15.72)、(116.25±17.61)]，观察组术后3月、6月TGF-β1相对表达量[(95.38±10.26)、(106.13±10.85)]均短于对照组[(104.25±11.63)、(115.39±10.37)]。结论：TCRP联合促性腺激素类药物亮丙瑞林可抑制EP患者复发，降低子宫内膜厚度，有助于改善患者预后。更多还原

【Abstract】 Objective To explore the effects of transcervical resection of endometrial polyps (TCRP) combined with gonadotropin drug leuprorelin on the recurrence rate and endometrial thickness of patients with endometrial polyps (EP).Methods A retrospective analysis was adopted on patients with EP patients treated in the hospital in this study.The clinical case data of 98 patients who met the standards were collected between July 2018 and July 2020,and the patients were divided into observation group (n=59,TCRP combined with leuprorelin) and control group (n=39,TCRP treatment alone) according to different treatment methods.All patients were treated with misoprostol tablets for cervical pretreatment before surgery and were reviewed regularly within 6 months after surgery (once every 3 months).The levels of serum follicle stimulating hormone (FSH),luteinizing hormone (LH) and estradiol (E2) and endometrial thickness and vascular endothelial growth factor (VEGF) and transforming growth factor-β1(TGF-β1) were compared between the two groups before surgery and at 3 and 6 months after surgery.The recurrence rate of endometrial polyps was compared at 3 and 6 months after surgery.Results The levels of FSH,LH and E2 at 3 and 6 months after surgery were [(3.85±0.98) IU/L,(3.62±0.86) IU/L,(70.82±10.26) pg/mL]and [(4.35±1.06) IU/L,(3.98±0.67) IU/L,(73.15±11.59) pg/mL]in observation group,which were all lower than [(5.52±1.18) IU/L,(4.98±1.27) IU/L,(89.25±11.35) pg/mL]and [(5.37±1.21) IU/L,(4.72±1.15) IU/L,(85.79±11.16) pg/mL]in control group.At 3 months and 6 months after surgery,the number of new EP recurrences with [(1/59,1.69%),(3/59,5.08%)]in observation group were lower than [(5/39,12.82%),(8/39,20.51%)]in control group,and the total recurrence rate of (4/59,6.77%) in observation group was significantly lower than (13/39,33.33%) in control group.The endometrial thickness,menstrual volume and menstrual period of the two groups of patients at 3 months and 6 months after surgery were significantly lower than those before surgery.The endometrial thickness with [(0.33±0.07) cm,(0.42±0.08) cm]of observation group was significantly thinner than [(0.52±0.11) cm,(0.79±0.15) cm]of control group at 3 months and 6 months after surgery,and the relative expression of VEGF protein with [(93.14±15.32),(100.59±18.93)]of observation group was significantly less than [(105.06±15.72),(116.25±17.61)]of control group,and the relative expression of TGF-β1 protein with [(95.38±10.26),(106.13±10.85)]was shorter than [(104.25±11.63),(115.39±10.37)]in control group.Conclusion TCRP combined with gonadotropin drug leuprorelin can inhibit the recurrence of patients with EP,reduce the endometrial thickness,and help improve the prognosis of patients.更多还原