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目的:比较单纯宫腔镜子宫内膜息肉电切术(TCRP)与术后口服达英—35、口服地屈孕酮对降低子宫内膜息肉复发率及药物不良反应的情况分析。方法:选取335例于2013年9月—2015年2月期间西北妇女儿童医院妇科收治的实施宫腔镜子宫内膜息肉电切术的患者,根据术后是否服药及口服不同药物将患者分为三组。观察组1为宫腔镜(TCRP)+口服达英—35组,共115例患者。术后第一次月经来潮第1天开始口服达英-35,每日一片,持续服药21天,然后停药,再次月经来潮的第一天开始下一周期用药,共6个周期;观察组2为宫腔镜(TCRP)+口服地屈孕酮组,共105例患者,术后第一次月经的后半期(即月经第14-21天服药),每日一片(10mg),连续服药6个周期;对照组为单纯宫腔镜手术(术后不用药物治疗),共115例患者。通过术后6个月定期复查阴道超声监测三组子宫内膜厚度、有无异常回声并宫腔镜复查以判断术后有无息肉复发,并比较服药期间发生不规则阴道出血情况及头晕、恶心等不良反应的发生率,共持续随访6个月,随访间隔时间为每月一次。结果:随访6个月,两术后加用药物的观察组与单纯手术的对照组的子宫内膜复发率组间差异有统计学意义(P>0.05);宫腔镜联合达英—35组与宫腔镜联合地屈孕酮组术后阴道不规则出血等副反应的发生率,两组间差异有统计学意义(P>0.05)。结论:术后口服达英—35及地屈孕酮对预防TCRP术后息肉复发都有明显效果,而服用达英-35组用药期间不规则阴道出血发生率显著低于口服地屈孕酮组。
Objective: To compare the results of simple hysteroscopic endometrial polyp resection (TCRP) and oral administration of da-Ying-35, oral dydrogesterone to reduce the recurrence rate of endometrial polyps and drug adverse reactions. METHODS: A total of 335 patients undergoing hysteroscopic endometrial polypectomy were enrolled in the Gynecology Department of Northwest Women and Children’s Hospital from September 2013 to February 2015. The patients were divided into Three groups. Observation group 1 was hysteroscopy (TCRP) + oral Darun-35 group, a total of 115 patients. The first menstrual cramps on the first day after oral administration of da-Ying -35, a day, continued medication for 21 days, and then withdrawal, again the first day of menstruation to start the next cycle of medication, a total of 6 cycles; observation group 2 for the TCRP + oral delivery of progesterone group, a total of 105 patients, the first post-menstrual period in the second half (ie menstrual medication 14-21 days), a daily (10mg), continuous medication 6 cycles; control group was hysteroscopic surgery alone (no drug treatment), a total of 115 patients. Vaginal ultrasound was used to monitor the thickness of the endometrium of the three groups regularly after 6 months of operation, whether there were abnormal echoes and hysteroscopy to determine the presence or absence of recurrence of polyps, and to compare the incidence of irregular vaginal bleeding and dizziness and nausea And other adverse reactions, a total of 6 months follow-up, follow-up interval of once a month. Results: After 6 months of follow-up, there was significant difference between the two groups in the rate of endometrial recurrence between the observation group treated with drugs and the control group (P> 0.05) There was significant difference between the two groups in the incidence of side effects such as irregular vaginal bleeding after vaginal bleeding in combination with hysteroscopy (P> 0.05). CONCLUSION: Postoperative oral daphnine-35 and dydrogesterone have a significant effect on the prevention of polyp recurrence after TCRP. The incidence of irregular vaginal bleeding during oral administration of da-Ying-35 group is significantly lower than that of oral dydrogesterone .