中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
30期
24-27
,共4页
避孕药,口服%宫腔镜检查%左炔诺孕酮宫内缓释系统%子宫内膜息肉
避孕藥,口服%宮腔鏡檢查%左炔諾孕酮宮內緩釋繫統%子宮內膜息肉
피잉약,구복%궁강경검사%좌결낙잉동궁내완석계통%자궁내막식육
Contraceptives,oral%Hysteroscopy%Levonorgestrel releasing intrauterine system%Endometrial polyp
目的 探讨子宫内膜息肉行宫腔镜手术后口服避孕药和宫腔内放置左炔诺孕酮宫内缓释系统(曼月乐)对预防术后复发的疗效.方法 选择行宫腔镜子宫内膜息肉切除术的患者174例,由患者知情并选择术后处理方式.51例在术后1个月开始服用避孕药12个月(避孕药组),60例在术后1个月于宫腔内放置曼月乐(曼月乐组),63例不进行任何预防复发处理(对照组).术后随访3,6,12个月,并比较三组复发率、月经量、血红蛋白和不良反应的情况.结果 避孕药组复发率为3.9％(2/51),曼月乐组为3.3％(2/60),对照组为19.0％(12/63),对照组的子宫内膜息肉复发率明显高于避孕药组和曼月乐组,差异有统计学意义(P＜0.05).对照组术后3,6,12个月月经量少的构成比明显低于避孕药组和曼月乐组,差异有统计学意义(P＜0.05).术后12个月对照组的血红蛋白明显低于避孕药组和曼月乐组[(124.55 ±9.33) g/L比(133.71±11.03),(135.89±6.88) g/L],差异有统计学意义(P＜0.05).曼月乐组不良反应发生率为18.3％(11/60),明显少于避孕药组的35.3％(18/51),差异有统计学意义(P＜0.05).结论 宫腔镜术后可以用口服避孕药或于宫腔内放置曼月乐来降低子宫内膜息肉复发率,曼月乐不良反应发生率更低,是治疗和预防子宫内膜息肉安全而有效的方法.
目的 探討子宮內膜息肉行宮腔鏡手術後口服避孕藥和宮腔內放置左炔諾孕酮宮內緩釋繫統(曼月樂)對預防術後複髮的療效.方法 選擇行宮腔鏡子宮內膜息肉切除術的患者174例,由患者知情併選擇術後處理方式.51例在術後1箇月開始服用避孕藥12箇月(避孕藥組),60例在術後1箇月于宮腔內放置曼月樂(曼月樂組),63例不進行任何預防複髮處理(對照組).術後隨訪3,6,12箇月,併比較三組複髮率、月經量、血紅蛋白和不良反應的情況.結果 避孕藥組複髮率為3.9％(2/51),曼月樂組為3.3％(2/60),對照組為19.0％(12/63),對照組的子宮內膜息肉複髮率明顯高于避孕藥組和曼月樂組,差異有統計學意義(P＜0.05).對照組術後3,6,12箇月月經量少的構成比明顯低于避孕藥組和曼月樂組,差異有統計學意義(P＜0.05).術後12箇月對照組的血紅蛋白明顯低于避孕藥組和曼月樂組[(124.55 ±9.33) g/L比(133.71±11.03),(135.89±6.88) g/L],差異有統計學意義(P＜0.05).曼月樂組不良反應髮生率為18.3％(11/60),明顯少于避孕藥組的35.3％(18/51),差異有統計學意義(P＜0.05).結論 宮腔鏡術後可以用口服避孕藥或于宮腔內放置曼月樂來降低子宮內膜息肉複髮率,曼月樂不良反應髮生率更低,是治療和預防子宮內膜息肉安全而有效的方法.
목적 탐토자궁내막식육행궁강경수술후구복피잉약화궁강내방치좌결낙잉동궁내완석계통(만월악)대예방술후복발적료효.방법 선택행궁강경자궁내막식육절제술적환자174례,유환자지정병선택술후처리방식.51례재술후1개월개시복용피잉약12개월(피잉약조),60례재술후1개월우궁강내방치만월악(만월악조),63례불진행임하예방복발처리(대조조).술후수방3,6,12개월,병비교삼조복발솔、월경량、혈홍단백화불량반응적정황.결과 피잉약조복발솔위3.9％(2/51),만월악조위3.3％(2/60),대조조위19.0％(12/63),대조조적자궁내막식육복발솔명현고우피잉약조화만월악조,차이유통계학의의(P＜0.05).대조조술후3,6,12개월월경량소적구성비명현저우피잉약조화만월악조,차이유통계학의의(P＜0.05).술후12개월대조조적혈홍단백명현저우피잉약조화만월악조[(124.55 ±9.33) g/L비(133.71±11.03),(135.89±6.88) g/L],차이유통계학의의(P＜0.05).만월악조불량반응발생솔위18.3％(11/60),명현소우피잉약조적35.3％(18/51),차이유통계학의의(P＜0.05).결론 궁강경술후가이용구복피잉약혹우궁강내방치만월악래강저자궁내막식육복발솔,만월악불량반응발생솔경저,시치료화예방자궁내막식육안전이유효적방법.
Objective To explore the recurrence-prevention effect of oral contraceptive and levonorgestrel-releasing intrauterine system (Mirena) after hysteroscopic endometrial polypectomy.Methods One hundred and seventy-four patients who received hysteroscopic endometrial polypectomy were enrolled in this research.The patients were informed and divided into three groups according to their selection:51 cases were given oral contraceptive since one month until 12 months after the surgery (oral contraceptive group); 60 cases were received Mirena since one month after the surgery (Mirena group) ; and 64 cases were received no treatment after the surgery (control group).The groups were followed up at 3,6,12 months after the surgery and compared the recurrence rate,menstruation,level of hemoglobin and complication rate.Results The recurrence rate in oral contraceptive group,Mirena group and control group was 3.9％(2/51),3.3％ (2/60) and 19.0％ (12/63),respectively.The recurrence rate in control group was higher than that in oral contraceptive group and Mirena group,and there was significant difference (P ＜ 0.05).The proportion of low menstruation volume in control group was lower than that in oral contraceptive group and Mirena group,and there was significant difference (P ＜ 0.05).The level of hemoglobin in control group was lower than that in oral contraceptive group and Mirena group [(124.55 ±9.33) g/L vs.(133.71 ± 11.03),(135.89 ±6.88) g/L],and there was significant difference (P ＜ 0.05).The incidence of complication in Mirena group [18.3％ (11/60)] was less than that in oral contraceptive group[35.3％(18/51)],and there was significant difference (P ＜ 0.05).Conclusions Oral contraceptive and Mirena after hysteroscopy for endometrial polys significantly decrease the recurrence rate.The complication rate of Mirena is lower and it is a safe and effective way to treat and prevent the endometrial polyp.
