CAJ | 학술논문

目的：探讨经宫腔镜子宫内膜息肉电切术(TCRP)后联合左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫内膜息肉(EP)的临床价值。方法选择2010年7月至2011年7月在陕西省宝鸡市中心医院行TCRP治疗的92例 EP患者为研究对象,按照入院顺序号将其随机分为研究组(n=46,TCRP+LNG-IUS)及对照组(n=46,TCRP)。比较两组患者术后不同随访时间月经量[采用月经失血图(PBAC)评分]、子宫内膜厚度、血红蛋白水平及 EP复发情况,并观察研究组不良反应(本研究遵循的程序符合陕西省宝鸡市中心医院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象知情同意,并与之签署临床研究知情同意书)。两组患者年龄、临床症状等一般情况比较,差异无统计学意义(P>0.05)。结果本研究结果为：①研究组月经量PBAC评分随访第3,9,12,18,24个月均显著低于对照组,且差异有统计学意义(t=3.12,4.12,4.14,4.67,4.76；P<0.01)；②研究组子宫内膜厚度随访第9,12,18,24个月均显著薄于对照组,且差异有统计学意义(t=2.55,2.68,2.89,3.12；P<0.05)；③研究组血红蛋白水平随访第3,9,12,18,24个月均显著高于对照组,且差异有统计学意义(t=1.02,2.10,2.41,2.56,2.76；P<0.05)；④研究组随访2年 EP总复发率显著低于对照组(0 vs.23.9%),且差异有统计学意义(χ2=12.32, P=0.004)。结论 TCRP联合 LNG-IUS治疗 EP能有效缓解患者月经过多症状,减少子宫内膜厚度,恢复血红蛋白水平并降低 EP复发率。
목적：탐토경궁강경자궁내막식육전절술(TCRP)후연합좌결낙잉동궁내완석계통(LNG-IUS)치료자궁내막식육(EP)적림상개치。방법선택2010년7월지2011년7월재합서성보계시중심의원행TCRP치료적92례 EP환자위연구대상,안조입원순서호장기수궤분위연구조(n=46,TCRP+LNG-IUS)급대조조(n=46,TCRP)。비교량조환자술후불동수방시간월경량[채용월경실혈도(PBAC)평분]、자궁내막후도、혈홍단백수평급 EP복발정황,병관찰연구조불량반응(본연구준순적정서부합합서성보계시중심의원인체시험위원회제정적윤리학표준,득도해위원회비준,분조정득수시대상지정동의,병여지첨서림상연구지정동의서)。량조환자년령、림상증상등일반정황비교,차이무통계학의의(P>0.05)。결과본연구결과위：①연구조월경량PBAC평분수방제3,9,12,18,24개월균현저저우대조조,차차이유통계학의의(t=3.12,4.12,4.14,4.67,4.76；P<0.01)；②연구조자궁내막후도수방제9,12,18,24개월균현저박우대조조,차차이유통계학의의(t=2.55,2.68,2.89,3.12；P<0.05)；③연구조혈홍단백수평수방제3,9,12,18,24개월균현저고우대조조,차차이유통계학의의(t=1.02,2.10,2.41,2.56,2.76；P<0.05)；④연구조수방2년 EP총복발솔현저저우대조조(0 vs.23.9%),차차이유통계학의의(χ2=12.32, P=0.004)。결론 TCRP연합 LNG-IUS치료 EP능유효완해환자월경과다증상,감소자궁내막후도,회복혈홍단백수평병강저 EP복발솔。
Objective To explore the clinical value of the levonorgestrel-releasing intrauterine system (LNG-IUS)in the treatment of endometrial polyps (EP)after transcervical resection of polyp (TCRP). Methods From July 2010 to July 2011,a total of 92 EP patients after TCRP surgery in Baoji Central Hospital were included.In accordance with the order of admission,they were randomly divided into research group(n=46,TCRP+LNG-IUS)and control group(n=46,TCRP).The menstrual blood volume [pictorial blood loss assessment chart (PBAC)score],endometrial thickness,hemoglobin level and EP recurrence rate were compared between two groups,and the adverse reactions of research group were observed at the same time.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Baoji Central Hospital.Informed consent was obtained from each patient.There were no significant difference in age,clinical symptoms and other general conditions between two groups(P>0.05).Results The results were:①The menstrual blood volume (PBAC score)of research group decreased significantly compared with that of control group in 3,9,12,18,24 months follow-up(t=3.12,4.12,4.14,4.67,4.76;P<0.01);②The endometrial thickness of research group were significantly thinner than that of control group in 9,12, 18,24 months follow-up(t=2.55,2.68,2.89,3.12;P<0.05);③Hemoglobin levels of research group were significantly higher than that of control group in 3,9,12,18,24 months follow-up(t=1.02,2.10,2.41, 2.56,2.76;P<0.05);④The EP recurrence rate of research group was significantly lower than that of control group (0 vs.23.9%)in 2-year follow up(χ2=12.32,P=0.004).Conclusions In the treatment of EP,TCPR combined with LNG-IUS can effectively alleviate menorrhagia,reduce endometrial thickness, recover hemoglobin level and reduce EP recurrence rate.