CAJ | 학술논문

目的：探讨屈螺酮炔雌醇预防宫腔镜下子宫内膜息肉切除术( transcervical resection of polyp, TCRP)术后息肉复发的效果。方法随机选取在解放军白求恩国际和平医院行TCRP的患者130例,根据自愿原则,将术后即开始服用屈螺酮炔雌醇的患者98例设为研究组,术后未服用屈螺酮炔雌醇且未行激素类药物治疗的32例设为对照组。观察比较两组子宫内膜厚度变化、术后月经恢复情况、息肉复发情况及研究组屈螺酮炔雌醇相关不良反应发生情况。结果随访12个月,研究组月经恢复正常者比例显著高于对照组( P<0．01),息肉复发者比例显著低于对照组(P<0．01)。术后3个月时超声检查两组子宫内膜厚度差异无统计学意义(P>0.05),术后6、12个月时研究组子宫内膜厚度显著薄于对照组(P<0．01)。研究组口服屈螺酮炔雌醇后发生头痛、恶心7例,月经间期出血5例,不良反应发生率为12.2%,症状均较轻,未行特殊处理；术后3、6、12个月复查肝、肾功能未见异常。结论术后口服屈螺酮炔雌醇对预防TCRP术后息肉复发效果显著且安全性好,同时可满足避孕要求,降低子宫内膜厚度,减少月经量。
목적：탐토굴라동결자순예방궁강경하자궁내막식육절제술( transcervical resection of polyp, TCRP)술후식육복발적효과。방법수궤선취재해방군백구은국제화평의원행TCRP적환자130례,근거자원원칙,장술후즉개시복용굴라동결자순적환자98례설위연구조,술후미복용굴라동결자순차미행격소류약물치료적32례설위대조조。관찰비교량조자궁내막후도변화、술후월경회복정황、식육복발정황급연구조굴라동결자순상관불량반응발생정황。결과수방12개월,연구조월경회복정상자비례현저고우대조조( P<0．01),식육복발자비례현저저우대조조(P<0．01)。술후3개월시초성검사량조자궁내막후도차이무통계학의의(P>0.05),술후6、12개월시연구조자궁내막후도현저박우대조조(P<0．01)。연구조구복굴라동결자순후발생두통、악심7례,월경간기출혈5례,불량반응발생솔위12.2%,증상균교경,미행특수처리；술후3、6、12개월복사간、신공능미견이상。결론술후구복굴라동결자순대예방TCRP술후식육복발효과현저차안전성호,동시가만족피잉요구,강저자궁내막후도,감소월경량。
Objective To investigate the effect of Drospirenone and Ethinylestradiol in prevention of endometrial polyps recurrence after transcervical resection of polyp ( TCRP) under hysteroscope. Methods A total of 130 patients with TCRP were randomly selected in this study, and were divided into the observation group (n=98) and the control group (n=32) according to the voluntary principle. The patients in the observation group immediately took Drospirenone and Ethinylestradiol tablets after the TCRP, while the patients in control group did not take Drospirenone and Ethi-nylestradiol tablets or amcinonide therapy. The changes of endometrium thickness, conditions of postoperative menstrua-tion recovery and endometrial polyps recurrence in the two groups were observed and compared, and the incidence rate of Drospirenone and Ethinylestradiol related adverse reactions in observation group was also analyzed. Results After 12 months of follow-up, the ratio of patients with normal menses was significantly higher, and the ratio of patients with endometrial polyps recurrent was significantly lower in the observation group than that in the control group ( P<0. 01 ) . There was no statistical significance in the changes of endometrium thickness by ultrasonography 3 rd month after the opera-tion in the two groups (P>0. 05), and the values of endometrial thickness in the 6th and 12th month after the operation in the observation group were significantly less than those in the control group (P<0. 01). In the observation group, 7 pa-tients suffered postoperative headache and nausea and 5 patients suffered intermenstrual bleeding, and the incidence rate of adverse reactions was 12. 2%, and the patients did not undergo any special treatment because of slight symptoms. No abnormal of liver and kidneys functions was found in the observation group with postoperative 3 rd , 6 th and 12 th month of medical examinations. Conclusion Oral Drospirenone and Ethinylestradiol after the TCRP for preventing postoperative polyp recurrence is effective and safe, and it also can meet the patients requirements of contraception at the same time, as well as decrease the endometrial thickness and menstrual volume.