摘要
目的:探讨宫腔镜下切除及术后应用左炔诺孕酮宫内缓释系统(曼月乐)治疗子宫内膜息肉的疗效及安全性。方法:总结、分析129例围绝经期患者经宫腔镜下切除及术后放置曼月乐治疗子宫内膜息肉的临床及随访资料。结果:全部患者宫腔镜手术均顺利完成,无手术并发症发生,术后病理结果为子宫内膜息肉,诊断性刮宫、子宫内膜病理结果排除子宫内膜恶性病变,于术后7～10日放置曼月乐。所有患者随访满2年,患者月经模式改变,月经过多者月经量明显减少,血红蛋白值明显升高,术前血红蛋白水平为(96.23±10.22)g/L,术后6、12、24个月血红蛋白值分别为(115.46±7.38)g/L、(120.16±8.23)g/L和(126.56±9.79)g/L,手术前与手术后各组血红蛋白值比较差异均有统计学意义(P<0.05);术前及术后6、12、24个月子宫内膜厚度分别为(1.48±0.36)cm、(0.78±0.22)cm、(0.69±0.16)cm和(0.58±0.13)cm,手术前与手术后子宫内膜厚度各组间比较差异均有统计学意义(P<0.001);无病例复发;术后患者血清雌、孕激素水平均无明显变化,无明显不良反应发生。结论:宫腔镜下切除及术后应用左炔诺孕酮宫内缓释系统治疗子宫内膜息肉临床效果肯定,可抑制子宫内膜增长,随访无复发病例,安全、有效,值得临床推广。
Objective：To explore the curative effects and safeties of hysteroscopic resection of polyp and postoperative application of levonorgestrel-releasing intrauterine system（Mirena） for endometrial polyp.Methods：The clinical data and follow-up data of one hundred and twenty-nine perimenopausal women who underwent hysteroscopic resection of polyp and postoperative application of Mirena were summarized and analyzed.Results：The operation was successfully completed for all the patients.No operative complications occurred,the postoperative pathological result was endometrial polyp,diagnostic uterine curettage and the pathological result of endometrium excluded malignant lesions of endometrium,Mirena was placed at 7-10 days after operation.All the patients were followed up for two years,the menstrual modes of the patients were changed,the menstrual volumes of the patients with menorrhagia reduced significantly,the levels of hemoglobin increased significantly,the average level of hemoglobin before operation was（96.23±10.22） g/L,while the average levels of hemoglobin at 6,12,and 24 months after operation were（115.46±7.38）g/L,（120.16±8.23）g/L,and（126.56±9.79）g/L,respectively,there was significant difference before and after operation（P0.05）;the thickness of endometrium before operation was（1.48±0.36） cm,while the thicknesses of endometrium at 6,12,and 24 months after operation were（0.78±0.22）cm,（0.69±0.16） cm,and（0.58±0.13） cm,respectively,there was significant difference before and after operation（P0.001）;no recurrence was found;after operation,the serum estrogen and progestogen levels of the patients didn＇t change obviously,no obvious adverse effects were observed.Conclusion：The curative effects of hysteroscopic resection of polyp and postoperative application of levonorgestrel-releasing intrauterine system are good for endometrial polyp,and they can inhibit the hyperplasia of endometrium,no recurrence is found,which are worthy to be popularized in clinic with the advantages of safety and effectiveness.
出处
《中国妇幼保健》
CAS
北大核心
2012年第6期920-922,共3页
Maternal and Child Health Care of China
