李姬梅+游金华+焦海花

[摘要]目的 探討醋酸环丙孕酮辅助宫腔镜子宫内膜息肉切除术对子宫内膜息肉的临床疗效。方法 选择2013年3月～2015年3月来我院治疗的88例子宫内膜息肉患者，利用计算机产生随机数字表将88例患者分为对照组和观察组各44例，对照组予以宫腔镜子宫内膜息肉切除术治疗，观察组则使用醋酸环丙孕酮辅助宫腔镜子宫内膜息肉切除术治疗。治疗后随访12个月，对比两组治疗前后子宫内膜厚度变化、月经失血评分（PBAC评分）、月经周期正常情况和随访期间复发情况。结果 治疗前，两组子宫内膜厚度比较，差异无统计学意义（P>0.05）；治疗后，两组的子宫内膜厚度变化均优于治疗前（P<0.05），治疗后3、6、12个月，观察组的子宫内膜厚度均低于对照组（P<0.05）。治疗前，两组PBAC评分比较，差异无统计学意义（P>0.05）；治疗后，两组PBAC评分随着时间的推移而减少（P<0.05），治疗后3、6、12个月，观察组分数低于对照组，差异有统计学意义（P<0.05）。治疗后两组月经周期正常率均呈阶梯状提高（P<0.05），而治疗后3、6、12个月观察组月经周期正常率均高于对照组（P<0.05）。随访期间对照组复发率为18.2%，高于观察组的2.3%，差异有统计学意义（P<0.05）。结论 应用醋酸环丙孕酮辅助宫腔镜子宫内膜息肉切除术治疗子宫内膜息肉具有较好的效果，可降低子宫内膜息肉的复发率，值得临床推广。

[关键词]醋酸环丙孕酮；宫腔镜；子宫内膜息肉

[中图分类号] R711 [文献标识码] A [文章编号] 1674-4721（2017）01（c）-0095-03

[Abstract]Objective To explore clinical effect of Cyproterone acetate assisted hysteroscopic endometrial polypectomy for endometrial polyps.Methods 88 patients with endometrial polyps treated in our hospital from March 2013 to March 2015 were randomly divided into control group and observation group by using a computer to generate a random number table，44 cases in each group.Patients in the control group were treated with hysteroscopic endometrial polypectomy treatment，while patients in the observation group were given with Cyproterone acetate assisted hysteroscopic endometrial polypectomy.Followed up for 12 months after treatment，endometrial thickness changes，menstrual blood loss score （PBAC score），normal menstrual cycle and recurrence during follow-up of two groups were compared before and after treatment.Results Before treatment，there was no statistical difference in endometrial thickness of two groups （P>0.05）；after treatment，endometrial thickness changes in two groups were better than that before treatment （P<0.05），3，6，and 12 months after treatment，endometrial thickness in the observation group was lower than that in the control group （P<0.05）.Before treatment，there was no statistical difference in PBAC score of two groups （P>0.05）；after treatment，PBAC score of two groups was decreased with time （P<0.05），3，6，12 months after treatment，PBAC score in the observation group score was lower than that in the control group，and the difference was statistically significant （P<0.05）.After treatment，normal rate of menstrual cycle in two groups showed a ladder improvement （P<0.05），and normal rate of menstrual cycle in the observation group was higher than that in the control group （P<0.05） 3，6，12 months after treatment.During follow-up，recurrence rate of the control group was 18.2%，which was higher than 2.3% of the observation group，and the difference was statistically significant （P<0.05）.Conclusion Cyproterone acetate assisted hysteroscopic endometrial polypectomy for endometrial polyps has a good effect，can reduce recurrence rate of endometrial polyps，it is worth clinical promotion.

[Key words]Cyproterone acetate；Hysteroscopy；Endometrial polyps

子宫内膜息肉是炎性病变的子宫内膜局部血管和结缔组织增生形成的息肉状赘生物向宫腔内突出而成，临床症状主要表现为月经量过多或不规则的子宫出血，该病的治疗主要为将息肉摘除[1]。目前临床常用的治疗方法是宫腔镜子宫内膜息肉切除术，该方法可有效地清除子宫内膜表面的息肉，但是对于肌层下息肉的血供难以清除，因此术后具有较高的复发率。有临床资料显示，在行宫腔镜子宫内膜息肉切除术时应用醋酸环丙孕酮辅助治疗，可提高治疗效果，降低子宫内膜息肉的复发率[2-3]。本研究分析醋酸环丙孕酮辅助宫腔镜子宫内膜息肉切除术对子宫内膜息肉的治疗效果，现报道如下。