目的:探讨宫腔镜下子宫内膜电切术(TCRE)联合左炔诺孕酮宫内缓释系统(LNG-IUS)治疗功能失调性子宫出血(DUB)的临床效果。方法:选择2010年1月~2012年11月在该院住院治疗(无生育要求且药物治疗无效)的DUB患者60例,随机分为观察组和对照组,每组各30例。观察组行TCRE治疗,并于术后1个月放置LNG-IUS,对照组行单纯TCRE治疗,比较两组患者术后的月经、宫腔积液、子宫内膜厚度、痛经等情况。结果:两组患者术后3、6、12个月PBAC评分与治疗前比较,差异均有统计学意义(P<0.05);观察组患者术后3、6、12个月闭经率(76.7%,93.4%,100.0%)与对照组(36.7%,56.7%,63.3%)比较,差异有统计学意义(P<0.05);观察组无复发及并发症,再次干预率(0.0%)与对照组(16.7%)比较,差异有统计学意义(P<0.05)。结论:采用宫腔镜下TCRE联合LNG-IUS治疗DUB临床疗效显著,可提高TCRE治愈率并有效减少术后并发症的发生。 Objective: To investigate the clinical effect of hysteroscopic endometrial electrotomy (TCRE) and levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of dysfunctional uterine bleeding (DUB). Methods: Sixty patients with DUB admitted to hospital from January 2010 to November 2012 were enrolled in this study. Patients in DUB group were randomly divided into observation group and control group with 30 cases in each group. The observation group was treated with TCRE. LNG-IUS was placed in the first month after surgery and the control group was treated with TCRE alone. Menstruation, uterine effusion, endometrial thickness and dysmenorrhea were compared between the two groups. Results: The PBAC scores at 3, 6 and 12 months after operation in both groups were significantly different from those before treatment (P <0.05). The rate of menses at 3, 6 and 12 months after operation in the observation group was 76.7% , 93.4% and 100.0% respectively) were significantly higher than those in the control group (36.7%, 56.7%, 63.3%) (P <0.05). No recurrence and complications were observed in the observation group. Group (16.7%), the difference was statistically significant (P <0.05). Conclusion: Hysteroscopic TCRE combined with LNG-IUS treatment of DUB significant clinical effect, can improve the cure rate of TCRE and effectively reduce the incidence of postoperative complications.