目的:分析左炔诺孕内节育系统的疗效,屈螺酮和炔雌醇片(II),地屈孕酮预防宫腔镜子宫内膜息肉切除术后子宫内膜息肉复发。
方法:2022年1月至2023年6月湖北省天门市第一人民医院妇科行宫腔镜子宫内膜息肉切除术的患者共77例,随机分为左炔诺孕内宫内节育组,屈螺酮和炔雌醇片(II)组,地屈孕酮组,和一个对照组。复发率,子宫内膜厚度,比较四组术后6个月和12个月的月经量变化。
结果:左炔诺孕宫内节育系统组的复发率,屈螺酮和炔雌醇片(II)组,地屈孕酮组低于对照组,具有统计学意义(P<0.01),左炔诺孕宫内节育系统组复发率最低。左炔诺孕内宫内节育器组术后6个月和12个月子宫内膜厚度,屈螺酮和炔雌醇片(II)组,地屈孕酮组比对照组薄,比术前薄,具有统计学意义(P<0.01)。左炔诺孕宫内节育器组术后3个月月经量,屈螺酮和炔雌醇片(II)组,地屈孕酮组明显少于对照组,并且小于操作前的体积。
结论:地屈孕酮,屈螺酮和炔雌醇片(II),和左炔诺孕内宫内节育器都起到预防子宫内膜息肉复发的作用,但左炔诺孕内节育系统在术后复发率方面明显优于地屈孕酮和屈螺酮炔雌醇片(II),子宫内膜厚度,月经变化,和合规性,值得临床推广应用。
OBJECTIVE: To analyze the efficacy of levonorgestrelintrauterine system, Drospirenone & ethinylestradiol tablets (II), and dydrogesterone in preventing the recurrence of endometrial polyps after hysteroscopic endometrial polypectomy.
METHODS: One hundred seventy patients who underwent hysteroscopic endometrial polypectomy in the Gynecology Department of Tianmen First People\'s Hospital in Hubei Province from January 2022 to June 2023 were randomly divided into the levonorgestrelintrauterine system group, Drospirenone & ethinylestradiol tablets (II) group, dydrogesterone group, and a control group. The recurrence rates, endometrial thickness, and menstrual volume changes at 6 and 12 months post-operation were compared among these four groups.
RESULTS: The recurrence rates in the levonorgestrelintrauterine system group, Drospirenone & ethinylestradiol tablets (II) group, and dydrogesterone group were lower than the control group, with statistical significance (P < 0.01), with the levonorgestrelintrauterine system group having the lowest recurrence rate. The endometrial thickness at 6 and 12 months post-operation in the levonorgestrelintrauterine system group, Drospirenone & ethinylestradiol tablets (II) group, and dydrogesterone group was thinner than that of the control group and thinner than pre-operation, with statistical significance (P < 0.01). The menstrual volume at 3 months post-operation in the levonorgestrelintrauterine system group, Drospirenone & ethinylestradiol tablets (II) group, and dydrogesterone group was significantly less than the control group, and less than the pre-operation volume.
CONCLUSIONS: Dydrogesterone, drospirenone & ethinylestradiol tablets (II), and levonorgestrelintrauterine system all play a role in preventing the recurrence of endometrial polyps, but levonorgestrelintrauterine system is significantly better than dydrogesterone and Drospirenone & ethinylestradiol tablets (II) in terms of postoperative recurrence rate, endometrial thickness, menstrual changes, and compliance, and is worth promoting in clinical application.