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目的探讨宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗子宫内膜息肉的效果及安全性。方法选取2011年10月-2013年10月在该院就诊行宫腔镜电切术治疗的子宫内膜息肉患者126例,采用随机数字表法分为两组,每组各63例。对照组采用屈螺酮炔雌醇片治疗,观察组采用左炔诺孕酮宫内缓释系统治疗。随访2年,每隔6个月进行体检,比较两组患者的月经失血图(PBAC)评分、子宫内膜厚度、血红蛋白、月经天数、不良反应、复发情况。结果随术后时间延长,两组患者的PBAC评分、子宫内膜厚度降低(P<0.05),血红蛋白水平升高(P<0.05),月经天数减少(P<0.05)。观察组患者术后6个月、12个月、18个月、24个月PBAC评分、子宫内膜厚度低于对照组(P<0.05),血红蛋白水平高于对照组(P<0.05),月经天数少于对照组(P<0.05)。观察组患者不良反应发生率、复发率低于对照组(P<0.05)。结论宫腔镜电切术联合左炔诺孕酮宫内缓释系统治疗子宫内膜息肉的效果显著,且安全性高,值得临床推广应用。
Objective To investigate the efficacy and safety of hysteroscopic electrotomy combined with levonorgestrel intrauterine system for the treatment of endometrial polyps. Methods A total of 126 patients with endometrial polyps undergoing hysteroscopic resection of the hospital from October 2011 to October 2013 were randomly divided into two groups (n = 63 in each group). The control group was treated with drospirenone ethinyl estradiol and the observation group was treated with levonorgestrel intrauterine sustained release system. The patients were followed up for 2 years and were inspected every 6 months. The PBAC scores, endometrial thickness, hemoglobin, days of menstruation, adverse reactions and relapse were compared between the two groups. Results With the prolongation of postoperative time, the PBAC score, the thickness of endometrium in both groups decreased (P <0.05), the levels of hemoglobin increased (P <0.05) and the days of menstruation decreased (P <0.05). PBAC score, endometrial thickness in observation group at 6, 12, 18 and 24 months after operation were lower than those in control group (P <0.05), hemoglobin levels were higher than those in control group (P <0.05) Days less than the control group (P <0.05). Adverse reactions in observation group patients, the recurrence rate was lower than the control group (P <0.05). Conclusion hysteroscopic combined with levonorgestrel intrauterine system for the treatment of endometrial polyps significant effect, and high safety, worthy of clinical application.