2μm激光切除术联合甲羟孕酮治疗子宫内膜息肉的效果观察
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摘要
目的分析2μm激光切除术联合甲羟孕酮治疗子宫内膜息肉的效果及对患者妊娠率、月经失血图(PBAC)评分的影响。方法将2016年1月至2017年1月间武汉市汉南区中医院妇产科收治的100例子宫内膜息肉患者依照随机信封法分为观察组和对照组,每组50例;对照组采用2μm激光切除术治疗,观察组采用2μm激光切除术联合甲羟孕酮治疗,以6个月为一个疗程;治疗结束后6个月及12个月对患者临床疗效进行评价,比较两组患者的子宫内膜厚度、PBAC评分、妊娠率、复发率及月经周期正常率。结果观察组患者的临床治疗总有效率为96.0%,明显高于对照组的78.00%,差异有统计学意义(P<0.05);治疗结束后6个月及12个月时,观察组患者的子宫内膜厚度分别为(4.73±0.84) mm和(2.67±0.45) mm,均明显低于对照组的(6.83±1.02) mm和(5.84±1.03) mm,PBAC评分分别为(56.82±10.39)分和(38.21±8.74)分,均明显低于对照组的(74.38±13.29)分和(50.29±9.13)分,差异均有统计学意义(P<0.05);治疗后观察组患者的妊娠率及月经周期正常率分别为42.00%和92.00%,明显高于对照组的20.00%和70.00%,且观察组患者的复发率仅为4.00%,明显低于对照组的26.00%,差异均有统计学意义(P<0.05)。结论采用2μm激光切除术联合甲羟孕酮治疗子宫内膜息肉后可有效提高临床疗效,并改善患者妊娠率、PBAC评分,具有较高的应用价值。
Objective To analyze the effect of 2 μm laser resection combined with Medroxyprogesterone in the treatment of endometrial polyps and its influence on the evaluation of pregnancy rate and pictorial blood loss assessment chart(PBAC). Methods From January 2016 to January 2017, 100 patients with endometrial polyps in our hospital were divided into the observation group and control group according to random envelope method, with 50 in each group. The control group was treated with 2 μm laser resection, and the observation group was treated with 2 μm laser resection combined with medroxyprogesterone, with 6 months as a course of treatment. Six months after treatment and twelve months after treatment, the clinical efficacy of the patients was evaluated, and endometrial thickness, PBAC score, pregnancy rate, recurrence rate and normal menstrual turnover rate of the two groups were analyzed. Results The total effective rate of the observation group was 96.00%, which was significantly higher than 78.00% of the control group(P<0.05).Six months and twelve months after treatment, the endometrial thickness and PBAC score of the observation group were(4.73±0.84) mm and(2.67±0.45) mm,(56.82±10.39) points and(38.21±8.74) points, respectively, which were significantly lower than corresponding(6.83±1.02) mm and(5.84±1.03) mm,(74.38±13.29) points and(50.29±9.13) points of the control group. After treatment, the pregnancy rate and the normal menstrual turnover rate in the observation group were 42.00% and 92.00%, respectively, which were significantly higher than corresponding 20.00% and 70.00% in the control group(P<0.05), and the recurrence rate in the observation group was 4.00%, which was significantly lower than26.00% in the control group(P<0.05). Conclusion In the treatment of endometrial polyps, 2 μm laser excision combined with methyl progesterone can effectively improve the clinical efficacy, and improve the pregnancy rate and PBAC score of patients, which has high application value.
Objective To analyze the effect of 2 μm laser resection combined with Medroxyprogesterone in the treatment of endometrial polyps and its influence on the evaluation of pregnancy rate and pictorial blood loss assessment chart(PBAC). Methods From January 2016 to January 2017, 100 patients with endometrial polyps in our hospital were divided into the observation group and control group according to random envelope method, with 50 in each group. The control group was treated with 2 μm laser resection, and the observation group was treated with 2 μm laser resection combined with medroxyprogesterone, with 6 months as a course of treatment. Six months after treatment and twelve months after treatment, the clinical efficacy of the patients was evaluated, and endometrial thickness, PBAC score, pregnancy rate, recurrence rate and normal menstrual turnover rate of the two groups were analyzed. Results The total effective rate of the observation group was 96.00%, which was significantly higher than 78.00% of the control group(P<0.05).Six months and twelve months after treatment, the endometrial thickness and PBAC score of the observation group were(4.73±0.84) mm and(2.67±0.45) mm,(56.82±10.39) points and(38.21±8.74) points, respectively, which were significantly lower than corresponding(6.83±1.02) mm and(5.84±1.03) mm,(74.38±13.29) points and(50.29±9.13) points of the control group. After treatment, the pregnancy rate and the normal menstrual turnover rate in the observation group were 42.00% and 92.00%, respectively, which were significantly higher than corresponding 20.00% and 70.00% in the control group(P<0.05), and the recurrence rate in the observation group was 4.00%, which was significantly lower than26.00% in the control group(P<0.05). Conclusion In the treatment of endometrial polyps, 2 μm laser excision combined with methyl progesterone can effectively improve the clinical efficacy, and improve the pregnancy rate and PBAC score of patients, which has high application value.
引文
[1]曾婷,李晓斌,曾晓娟.绝经后妇女子宫内膜息肉发病相关因素分析[J].海南医学, 2016, 27(16):2640-2642.
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[5] MUZII L, DI DONATO V, BONI T, et al. Antibiotics prophylaxis for operative hysteroscopy:a multicenter randomized controlled clinical study[J]. Reproductive Sciences, 2017, 24(4):534-538.
[6]朱兆领,袁建军,王睿丽,等.宫腔声学造影诊断剖宫产术后子宫切口憩室的价值[J].中国医学影像技术, 2017, 33(4):558-561.
[7] FAMUYIDE AO, LAUGHLIN-TOMMASO SK, SHAZLY SA, et al.Medical therapy versus radiofrequency endometrial ablation in the initial treatment of heavy menstrual bleeding(iTOM Trial):a clinical and economic analysis[J]. PLoS One, 2017, 12(11):e0188176.
[8] CELIK O, ACET M, KUCUK T, et al. Surgery for benign gynecological disorders improve endometrium receptivity:a systematic review of the literature[J]. Reproductive Sciences, 2017, 24(2):174-192.
[9]吴雯君,丁秀丽.屈螺酮炔雌醇片治疗宫腔镜下子宫内膜息肉电切术后的效果及对子宫内膜息肉复发的预防作用[J].中国妇幼保健,2017, 32(17):4284-4286.
[10] BIRCH JC, KHATRI G, WATUMULL LM, et al. Unintended consequences of systemic and ablative oncologic therapy in the abdomen and pelvis[J]. Radio Graphics, 2018, 38(4):1158-1179.
[11] FAMUYIDE A. Endometrial Ablation[J]. Journal of Minimally Invasive Gynecology, 2018, 25(2):299-307.
[12]王晓雷,李文学,臧红霞,等.宫腔镜电切术治疗Ⅱ型子宫黏膜下肌瘤两种切除方法对生殖预后的影响[J].中国实用妇科与产科杂志,2017, 33(4):423-427.
[13] CHAUDHARI L, SATIA MN. To study the correlation between endometrial thickness on transvaginal sonography and endometrial histopathology in women with postmenopausal bleeding[J]. International Journal of Reproduction, Contraception, Obstetrics and Gynecology,2017, 5(5):1309-1315.
[14]李仕珍,邓晓惠.盆腔子宫内膜异位症合并不孕患者术后妊娠相关因素分析[J].国际生殖健康/计划生育杂志, 2017, 36(4):291-294.
[15] RORDIGUZE-MIAS NL, CUBO-ABERT M, FERNANDEZ-OLIVA A, et al. Abdominal ultrasound assessment during operative hysteroscopy:a case series[J]. Journal of Gynecologic Surgery, 2018, 34(2):95-98.
[2] ELIAS LV, SPADOTO-DIAS D, LEITE NJ, et al. Comparative study between endometrial resection and electrocoagulation in patients with abnormal uterine bleeding[J]. Open Journal of Obstetrics and Gynecology, 2017, 7(3):312-325.
[3]聂明月,张佟,张博,等.绝经前及绝经后子宫内膜息肉的临床分析[J].北京医学, 2017, 39(11):1107-1110.
[4]覃晓,徐文生.子宫内膜息肉诊治进展[J].广西医科大学学报,2015, 32(6):1022-1024.
[5] MUZII L, DI DONATO V, BONI T, et al. Antibiotics prophylaxis for operative hysteroscopy:a multicenter randomized controlled clinical study[J]. Reproductive Sciences, 2017, 24(4):534-538.
[6]朱兆领,袁建军,王睿丽,等.宫腔声学造影诊断剖宫产术后子宫切口憩室的价值[J].中国医学影像技术, 2017, 33(4):558-561.
[7] FAMUYIDE AO, LAUGHLIN-TOMMASO SK, SHAZLY SA, et al.Medical therapy versus radiofrequency endometrial ablation in the initial treatment of heavy menstrual bleeding(iTOM Trial):a clinical and economic analysis[J]. PLoS One, 2017, 12(11):e0188176.
[8] CELIK O, ACET M, KUCUK T, et al. Surgery for benign gynecological disorders improve endometrium receptivity:a systematic review of the literature[J]. Reproductive Sciences, 2017, 24(2):174-192.
[9]吴雯君,丁秀丽.屈螺酮炔雌醇片治疗宫腔镜下子宫内膜息肉电切术后的效果及对子宫内膜息肉复发的预防作用[J].中国妇幼保健,2017, 32(17):4284-4286.
[10] BIRCH JC, KHATRI G, WATUMULL LM, et al. Unintended consequences of systemic and ablative oncologic therapy in the abdomen and pelvis[J]. Radio Graphics, 2018, 38(4):1158-1179.
[11] FAMUYIDE A. Endometrial Ablation[J]. Journal of Minimally Invasive Gynecology, 2018, 25(2):299-307.
[12]王晓雷,李文学,臧红霞,等.宫腔镜电切术治疗Ⅱ型子宫黏膜下肌瘤两种切除方法对生殖预后的影响[J].中国实用妇科与产科杂志,2017, 33(4):423-427.
[13] CHAUDHARI L, SATIA MN. To study the correlation between endometrial thickness on transvaginal sonography and endometrial histopathology in women with postmenopausal bleeding[J]. International Journal of Reproduction, Contraception, Obstetrics and Gynecology,2017, 5(5):1309-1315.
[14]李仕珍,邓晓惠.盆腔子宫内膜异位症合并不孕患者术后妊娠相关因素分析[J].国际生殖健康/计划生育杂志, 2017, 36(4):291-294.
[15] RORDIGUZE-MIAS NL, CUBO-ABERT M, FERNANDEZ-OLIVA A, et al. Abdominal ultrasound assessment during operative hysteroscopy:a case series[J]. Journal of Gynecologic Surgery, 2018, 34(2):95-98.