本文選題：TCRP + 子宮內(nèi)膜息肉��； 參考：《青島大學(xué)》2014年碩士論文

【摘要】：目的：觀察宮腔鏡下子宮內(nèi)膜息肉電切術(shù)(transcervical resection of endometrial polyps, TCRP)后放置左炔諾孕酮宮內(nèi)緩釋系統(tǒng)(levonorgestrel-releasing intrauterine system, LNG-IUS,商品名Mirena)預(yù)防子宮內(nèi)膜息肉(endometrial polyps)復(fù)發(fā)的療效。 方法：收集本院近期經(jīng)宮腔鏡診治的子宮內(nèi)膜息肉的病例315例,其中單純性子宮內(nèi)膜息肉198例,子宮內(nèi)膜息肉合并子宮腺肌病38例,子宮內(nèi)膜息肉合并子宮肌瘤40例,乳腺癌術(shù)后口服他莫昔芬合并子宮內(nèi)膜息肉39例,行子宮內(nèi)膜息肉電切術(shù)后,單純性子宮內(nèi)膜息肉(A組)中隨機(jī)分為三組,研究組①(TCRP+曼月樂(lè))65例,宮腔鏡下內(nèi)膜息肉切除術(shù)后放置左炔諾孕酮宮內(nèi)緩釋系統(tǒng)；研究組②(TCRP+甲羥孕酮)68例,宮腔鏡下內(nèi)膜息肉切除術(shù)后于術(shù)后第一次月經(jīng)的第15天口服醋酸甲羥孕酮10mg／d,連服10天,重復(fù)上述方法3月；對(duì)照組(TCRP)65例,宮腔鏡下內(nèi)膜息肉切除術(shù)后無(wú)任何治療措施。比較3組患者12個(gè)月子宮內(nèi)膜息肉復(fù)發(fā)率。其余患者(即合并其它疾病者為B組)117例,行宮腔鏡下子宮內(nèi)膜息肉切除術(shù)后,隨機(jī)分為二組,研究組(TCRP+曼月樂(lè))59例,宮腔鏡下內(nèi)膜息肉切除術(shù)后放置左炔諾孕酮宮內(nèi)緩釋系統(tǒng)；對(duì)照組58例,宮腔鏡下內(nèi)膜息肉切除術(shù)后無(wú)任何治療措施。比較2組患者12個(gè)月子宮內(nèi)膜息肉復(fù)發(fā)率。 結(jié)果：A組單純性子宮內(nèi)膜息肉組三組(即研究組①、研究組②、對(duì)照組)復(fù)發(fā)率分別為0%,6.45%,24.62%,研究組①(TCRP+曼月樂(lè))、研究組②(TCRP+甲羥孕酮)分別與對(duì)照組比較,子宮內(nèi)膜息肉復(fù)發(fā)率均明顯降低(P0.05),差異有統(tǒng)計(jì)學(xué)意義；研究組①(TCRP+曼月樂(lè))子宮內(nèi)膜息肉復(fù)發(fā)率明顯低于研究組②(TCRP+甲羥孕酮)(P0.05),差異有統(tǒng)計(jì)學(xué)意義。B組中曼月樂(lè)組復(fù)發(fā)率為1.7%,對(duì)照組復(fù)發(fā)率為25.85%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論：宮腔鏡下子宮內(nèi)膜息肉切除術(shù)聯(lián)合左炔諾孕酮宮內(nèi)緩釋系統(tǒng)能有效預(yù)防子宮內(nèi)膜息肉復(fù)發(fā)。
[Abstract]:Objective: to observe the efficacy of levonorgestrel-releasing intrauterine system (LNG-IUSS) in preventing the recurrence of endometrial polyps by transcertial resection of endometrial polyps, TCRP). Methods: a total of 315 cases of endometrial polyps, including 198 cases of simple endometrial polyps, 38 cases of endometrial polyps with adenomyosis and 40 cases of endometrial polyps with uterine leiomyoma, were collected. Thirty-nine patients with endometrial polyps were treated with tamoxifen combined with endometrial polyps after operation. The patients were randomly divided into three groups: group A, simple endometrial polyp after resection of endometrial polyps, and study group (n = 65). After hysteroscopic resection of endometrial polyps, levonorgestrel was placed in the intrauterine release system. The study group included 68 patients with 2(TCRP medroxyprogesterone, and 10 mg / d of medroxyprogesterone acetate was taken orally after hysteroscopic resection of endometrial polyps on the 15th day of the first menstrual period after hysteroscopy, 10 mg / d of medroxyprogesterone acetate was administered for 10 days. The results showed that 65 cases of TCRP were treated with hysteroscopic resection of endometrial polyps without any treatment. To compare the recurrence rate of endometrial polyps in 3 groups at 12 months. The remaining patients (group B, 117 patients with other diseases) were randomly divided into two groups after hysteroscopic resection of endometrial polyps. After hysteroscopic resection of endometrial polyps, levonorgestrel was placed in the intrauterine release system, while in the control group, there was no treatment after hysteroscopic resection of endometrial polyps. The recurrence rate of endometrial polyps at 12 months was compared between the two groups. Results the recurrence rates of simple endometrial polyp group (study group 1, study group 2, control group) were 0, 6.45 and 24.62, respectively. 1(TCRP and 2(TCRP in study group were compared with those in control group. The recurrence rate of endometrial polyps decreased significantly (P 0.05). The recurrence rate of endometrial polyps in the study group was significantly lower than that in the study group (2(TCRP medroxyprogesterone) P0.05.The difference was statistically significant. In group B, the recurrence rate of Manyue group was 1.7 and that of control group was 25.85. The difference between the two groups was statistically significant (P 0.05). Conclusion: hysteroscopic resection of endometrial polyps combined with levonorgestrel intrauterine slow release system can effectively prevent the recurrence of endometrial polyps.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R713.4

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