目的：分析宫腔镜子宫内膜息肉电切术联合曼月乐治疗子宫内膜息肉（ EP）的临床效果。方法选取2011年11月至2013年11月在陕西中医药大学第二附属医院妇科治疗的68例EP患者，采用宫腔镜子宫内膜息肉电切术（ TCRP）一次性去除EP，术后按患者的意愿分组，对照组：35例，单纯行TCRP术，术后无任何其它治疗；观察组：33例，行TCRP治疗后宫内放置曼月乐（ LNG-IUS）。观察两组术前及术后第1、6、12个月子宫内膜厚度，并随访术后24个月的复发情况。结果术前及术后1个月两组子宫内膜厚度比较均无统计学意义（均P＞0．05）；随着治疗时间的延长，子宫内膜逐渐变薄，术后6、12个月时观察组子宫内膜厚度较对照组同期明显变薄（t值分别为2．445、2．732，均P＜0．05）；术后24个月观察组有2例复发，占6．06％，对照组8例复发，占22．86％，两组比较差异有统计学意义（χ2＝7．236，P＜0．05）。结论宫腔镜子宫内膜息肉电切术后联合曼月乐可抑制子宫内膜增生，并明显降低EP的复发率，值得在临床推广应用。%Objective To observe the clinical efficacy of transcervical resection of polyps (TCRP) combining with levonorgestrel-releasing intrauterine system ( LNG-IUS) in the treatment of endometrial polyp ( EP) .Methods From November 2011 to November 2013 totally 68 cases of EP treated in the Second Affiliated Hospital of Shaanxi University of Chinese Medicine were selected , and their EP were cut with TCRP.According to patient’s wishes, they were divided into control group (35 cases) with simple TCRP and no other therapy after surgery and observation group (38 cases) with TCRP combining LNG-IUS.The endometrial thickness before operation and 1, 6 and 12 months after operation in two groups were observed .A follow-up visit was paid to observe the recurrence during 24 months after operation . Results Endometrial thickness before operation and 1 month after operation was not statistically different between two groups ( both P>0.05).With the prolonging of treatment time , the endometrial thickness gradually became less .The endometrial thickness in the observation group in 6 and 12 months after operation was significantly less than that in the control group ( t value was 2.445 and 2.732, respectively, both P<0.05).After 24 months, 2 cases had recurrence (6.06%) in the observation group and 8 (22.86%) in the control group.The difference between two groups was statistically significant (χ2 =7.236,P<0.05).Conclusion TCRP in combined with LNG-IUS in the treatment of EP can inhibit endometrial hyperplasia and reduce the recurrence rate of EP obviously .It is worthy of clinical popularization and application .
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