摘要
目的探讨甲羟孕酮联合宫腔镜电切(TCRP)术治疗子宫内膜息肉的疗效及对患者血清血管内皮生长因子(VEGF)和性激素水平的影响。方法选取连州市妇幼保健计划生育服务中心妇科2019年8月至2020年10月收治的60例子宫内膜息肉患者为研究对象。按照随机数表法将所有患者分为观察组和对照组,每组30例,观察组患者给予甲羟孕酮联合TCRP术治疗,对照组仅使用TCRP术治疗。治疗6个月比较两组患者的子宫内膜厚度、月经量、性激素卵泡刺激素(FSH)和黄体生成素(LH)水平、月经正常率、复发率、并发症发生率,同时比较两组患者术前24h、术后1个月、术后3个月、术后6个月的血清VEGF水平。结果观察组患者治疗6个月的子宫内膜厚度和月经量分别为(5.56±0.52)mm、(71.48±6.44)mL,明显小(少)于对照组的(7.23±0.83)mm、(100.32±10.83)mL,差异均有统计学意义(P<0.05);观察组患者治疗后的性激素LH、FSH水平分别为(5.12±0.47)mIU/mL、(5.98±0.54)mIU/mL,明显低于对照组的(6.64±0.93)mIU/mL、(6.84±0.81)mIU/mL,差异均有统计学意义(P<0.05);观察组患者治疗6个月后的复发率为3.33%,明显低于对照组的20.00%,月经正常率为93.33%,明显高于对照组的73.33%,差异均有统计学意义(P<0.05);观察组和对照组患者治疗6个月后的并发症发生率分别为3.33%,10.00%,差异无统计学意义(P>0.05);观察组患者术后1个月、术后3个月、术后6个月的血清VEGF水平分别为(30.27±2.65)ng/L、(40.21±4.53)ng/L、(47.51±5.36)ng/L,明显低于对照组的(38.64±3.78)ng/L、(55.54±6.29)ng/L、(76.56±6.45)ng/L,差异均有统计学意义(P<0.05)。结论甲羟孕酮联合TCRP术治疗子宫内膜息肉可抑制患者子宫内膜增生,改善血清VEGF和性激素水平,减少术后复发,安全性高,值得临床推广应用。
Objective To investigate the curative effect of medroxyprogesterone combined with hysteroscopic resection(TCRP)in the treatment of endometrial polyps and its influence on serum vascular endothelial growth factor(VEGF)and sex hormone levels.Methods Sixty patients with endometrial polyps in Lianzhou Maternal and Child Health and Family Planning Service Center from August 2019 to October 2020 were selected as the research objects.According to the random number table method,all patients were divided into the observation group and the control group,with 30 patients in each group.The observation group was treated with medroxyprogesterone combined with TCRP,and the control group was only treated with TCRP.After 6 months of treatment,the endometrial thickness,menstrual volume,sex hormone follicle stimulating hormone(FSH)and luteinizing hormone(LH)levels,normal menstruation rate,recurrence rate and complication rate of the two groups were compared,and the serum VEGF levels of the two groups 24 hours before operation,1 month after operation,3 months after operation and 6 months after operation were compared.Results The endometrial thickness and menstrual volume of the observation group after treatment were(5.56±0.52)mm and(71.48±6.44)mL,respectively,which were significantly smaller(less)than(7.23±0.83)mm and(100.32±10.83)mL in the control group(P<0.05);the levels of sex hormones LH and FSH in the observation group after treatment were(5.12±0.47)mIU/mL and(5.98±0.54)mIU/mL,which were significantly lower than(6.64±0.93)mIU/mL and(6.84±0.81)mIU/mL in the control group(P<0.05);the postoperative recurrence rate in the observation group was 3.33%,which was significantly lower than 20.00%in the control group,and the normal menstrual rate was 93.33%,which was significantly higher than 73.33%in the control group,with statistically significant differences(P<0.05).The incidence of complications in the observation group and the control group after 6 months of treatment were 3.33%and 10.00%,respectively,and the difference was not statistically significant(P>0.05).The serum VEGF levels of patients in the observation group were(30.27±2.65)ng/L,(40.21±4.53)ng/L,and(47.51±5.36)ng/L at 1 month,3 months,and 6 months after surgery,significantly lower than(38.64±3.78)ng/L,(55.54±6.29)ng/L,(76.56±6.45)ng/L in the control group(P<0.05).Conclusion Medroxyprogesterone combined with TCRP in the treatment of endometrial polyps can inhibit endometrial hyperplasia,improve serum VEGF and sex hormone levels,reduce postoperative recurrence,and have high safety,which is worthy of clinical application.
作者
郑贺
李玉玲
黄燕萍
ZHENG He;LI Yu-ling;HUANG Yan-ping(Department of Gynecology,Lianzhou Maternal and Child Health and Family Planning Service Center,Qingyuan 513400,Guangdong,CHINA)
出处
《海南医学》
CAS
2021年第9期1140-1143,共4页
Hainan Medical Journal
基金
广东省清远市科技计划项目(编号:190903154567356)。
关键词
子宫内膜息肉
甲羟孕酮
宫腔镜电切术
血管内皮生长因子
性激素
复发
Endometrial polyps
Medroxyprogesterone
Hysteroscopic resection
Vascular endothelial growth factor
Sex hormone
Relapse
作者简介
通讯作者:郑贺,E-mail:13425258880@139.com。
