继续医学教育
繼續醫學教育
계속의학교육
Continuing Medical Education
2015年
11期
120-122
,共3页
子宫内膜息肉%左炔诺孕酮宫内缓释节育系统%促性腺激素释放激素的激动剂%复发%宫腔镜
子宮內膜息肉%左炔諾孕酮宮內緩釋節育繫統%促性腺激素釋放激素的激動劑%複髮%宮腔鏡
자궁내막식육%좌결낙잉동궁내완석절육계통%촉성선격소석방격소적격동제%복발%궁강경
Endometrial polyps%Levonorgestrel releasing intrauterine system%Gonadotropin releasing hormone agonist%Recurrent%Hysteroscopy
目的:通过比较左炔诺孕酮宫内缓释节育系统(LNG-IUS,曼月乐)与促性腺激素释放激素的激动剂(GnRH-a)对复发性子宫内膜息肉患者术后复发率的差异,为临床选择术后治疗方式提供依据。方法将复发性子宫内膜息肉术后患者按是接受放置曼月乐还是使用GnRH-a药物治疗分两组,放置曼月乐环为病例组,注射GnRH-a为对照组,每组各30例,曼月乐组患者于术后即放置或下次月经干净后3~5 d放置曼月乐宫内节育系统;GnRH-a药物组患者于术后第2天注射达菲林3.75 mg,28天重复一次,连续治疗2~3个周期。结果分别于宫腔镜下子宫内膜电切术后第1、2、3年随访,1年复发率曼月乐组为0(0/30),GnRH-a组为3.3%(1/30),2年复发率曼月乐组为0(0/30),GnRH-a组为6.6%(2/30),3年复发率曼月乐组为3.3%(1/30),GnRH-a组为13.2%(4/30),曼月乐组与GnRH-a组比较差异均有统计学意义(P<0.05)。结论复发性子宫内膜息肉患者宫腔镜术后曼月乐组的复发率低于GnRH-a组,故曼月乐环抑制复发性子宫内膜息肉复发的效果优于GnRH-a组,曼月乐环抑制复发性子宫内膜息肉复发的远期临床疗效较好。
目的:通過比較左炔諾孕酮宮內緩釋節育繫統(LNG-IUS,曼月樂)與促性腺激素釋放激素的激動劑(GnRH-a)對複髮性子宮內膜息肉患者術後複髮率的差異,為臨床選擇術後治療方式提供依據。方法將複髮性子宮內膜息肉術後患者按是接受放置曼月樂還是使用GnRH-a藥物治療分兩組,放置曼月樂環為病例組,註射GnRH-a為對照組,每組各30例,曼月樂組患者于術後即放置或下次月經榦淨後3~5 d放置曼月樂宮內節育繫統;GnRH-a藥物組患者于術後第2天註射達菲林3.75 mg,28天重複一次,連續治療2~3箇週期。結果分彆于宮腔鏡下子宮內膜電切術後第1、2、3年隨訪,1年複髮率曼月樂組為0(0/30),GnRH-a組為3.3%(1/30),2年複髮率曼月樂組為0(0/30),GnRH-a組為6.6%(2/30),3年複髮率曼月樂組為3.3%(1/30),GnRH-a組為13.2%(4/30),曼月樂組與GnRH-a組比較差異均有統計學意義(P<0.05)。結論複髮性子宮內膜息肉患者宮腔鏡術後曼月樂組的複髮率低于GnRH-a組,故曼月樂環抑製複髮性子宮內膜息肉複髮的效果優于GnRH-a組,曼月樂環抑製複髮性子宮內膜息肉複髮的遠期臨床療效較好。
목적:통과비교좌결낙잉동궁내완석절육계통(LNG-IUS,만월악)여촉성선격소석방격소적격동제(GnRH-a)대복발성자궁내막식육환자술후복발솔적차이,위림상선택술후치료방식제공의거。방법장복발성자궁내막식육술후환자안시접수방치만월악환시사용GnRH-a약물치료분량조,방치만월악배위병례조,주사GnRH-a위대조조,매조각30례,만월악조환자우술후즉방치혹하차월경간정후3~5 d방치만월악궁내절육계통;GnRH-a약물조환자우술후제2천주사체비림3.75 mg,28천중복일차,련속치료2~3개주기。결과분별우궁강경하자궁내막전절술후제1、2、3년수방,1년복발솔만월악조위0(0/30),GnRH-a조위3.3%(1/30),2년복발솔만월악조위0(0/30),GnRH-a조위6.6%(2/30),3년복발솔만월악조위3.3%(1/30),GnRH-a조위13.2%(4/30),만월악조여GnRH-a조비교차이균유통계학의의(P<0.05)。결론복발성자궁내막식육환자궁강경술후만월악조적복발솔저우GnRH-a조,고만월악배억제복발성자궁내막식육복발적효과우우GnRH-a조,만월악배억제복발성자궁내막식육복발적원기림상료효교호。
Objective To compare the differences between levonorgestrel releasing intraute system(LNG-IUS, Mirena) with Gonadotropin releasing hormone agonist (GnRH-a) for recurrence rate in patients with recurrence of endometrial polyps afer hysteroscopic polypectomy. Provide the basis for the select postoperative treatment in clinical work. Methods The recurrent endometrial polyp patients are divided by placing Mirena or the use of GnRH-a therapy in two groups, placed Mirena ring for the case group, injected GnRH-a for the control group, 30 cases in each group, the patients in mirena group place Mirena intrauterine system after surgery or 3~5 days after the next menstrual clean, the patients of GnRH-a group inject Diphereline 3.75 mg in the next day afer opeation, 28-day repeated once, last for 2 to 3 cycles of treatment. Results Follow-up is performed Respectively after 1, 2, 3 years of hysteroscopic polypectomy, 1-year recurrence rate of Mirena group was 0 (0/30), GnRH-a group was 3.3% (1/30), 2-year recurrence rate Mirena group was 0 (0/30), GnRH-a group was 6.6% (2/30), 3-year recurrence rate of Mirena group was 3.3% (1 / 30), GnRH-a group was 13.2% (4/30), the differences between Mirena group and GnRH-a group are statistically signiifcant (P<0.05).Conclusion The recurrence rate of Mirena group is lower than GnRH-a group in patients with recurrent endometrial polyps after hysteroscopic polypectomy, so Mirena ring group is better than GnRH-a group in suppress recurrent of endometrial polyps ,the long-term clinical efifcacy of Mirena ring is better in the suppression of recurrent endometrial polyps.