宫腔镜子宫内膜息肉切除术后口服避孕药或放置左炔诺孕酮宫内缓释系统对预防复发的作用中国微创外科杂志2013年3月第13卷第3期ChinJMinInvSurg,March2013,Vo1.13.No.3249临床论著宫腔镜子宫内膜息肉切除术后口服避孕药或放置左炔诺孕酮宫内缓释系统对预防复发的作用王威王晓晔(北京大学第三医院妇产科，北京100191)【摘要】目的果。方法探讨子宫内膜息肉宫腔镜手术后口服避孕药或放置左炔诺孕酮宫内缓释系统(曼月乐)对预防复发的效2009年1月_2011年10月门诊宫腔镜子宫内膜息肉切除术且病理证实为子宫内膜息肉116例，由患者知情选择术后处理方法。34例官腔镜手术后1个月开始应用复方短效口服避孕药12个月(避孕药组),39例官腔镜术后1个月放置曼月乐(曼月乐组),43例仅行官腔镜手术切除息肉(对照组)。术后3、6、12个月随访，比较3组复发率，以及月经和血红蛋白情况。结果术后均完成12个月随访。复发率避孕药组2.9%(1/34),曼月乐组2.6%(1/39),对照组18.6%(8/43),3组间复发率差异有显著性(=8.649,P=0.013),对照组复发率是另外2组的6倍。术后3、6、12个月避孕药组和曼月乐组月经量少的构成比均明显高于对照组(P=0.000)。术后12个月避孕药组和曼月乐组血红蛋白明显高于对照组(P_lt;0.05)。结论官腔镜术后应用复方短效口服避孕药或左炔诺孕酮宫内缓释系统可以降低子宫内膜息肉复发率，不良反应轻，创伤小，值得临床推广。【关键词】子宫内膜息肉；宫腔镜；复方短效口服避孕药；左炔诺孕酮宫内缓释系统中图分类号：R711.7文献标识：A文章编号：1009—6604(2013)03—0249—04EficfacyofOralC0ntraceptiveorLeVon0rgestrel-releasingIntrauterineSystemafterHysterOsc0picEndometrialPolypectomyinPreventingRecurrenceWangWei,Wang_iaoye.DepartmentofObstetricsandGynecology,PekingUniversityThirdHospital,Beijing100191,China【Abstract】objectiveToinvestigatetherecurrence-preventioneffectoforalcontraceptiveorlevonorgestrel-releasingMethodsTotally116patients,whoreceivedintrauterinesystem(Mirena)atferhysteroscopicendometrialpolypectomy.hysteroscopicendometrialpolypectomyandwereconirfmedwithendometrialpolypbypostoperativepathologicale_aminationduringJanuary2009andOctober2011inourhospital,wereenrolledintothisstudy.Thepatientsweredividedintothreegroups:oralcontraceptivegroup(n=34)wasgivencombinedoralcontraceptivesinceonemonthuntil12monthsatfertheoperation;Mirenagroup(n=39)receivedlevonorgestrel-releasingintrauterinesystemsinceonemonthatfertheoperation;andcontrolgroup(n=43)receivednotreatmentatefrhysteroscopicendometrialpolypectomy.Thethreegroupswerefollowedupat3,6,and12monthsatefrtheprocedure,andtherecurrencerate,menstruation,andlevelofhemoglobinwerecomparedamongthegroups.ResultsNopatientswerelostduringa12一monthfollow—up.Thecontrolgroupshowedsignificantlyhigherrecurrencerate,lowerproportionoflowmenstruationvolumeandlowerlevelofhemoglobinthantheoralcontraceptiveandMirenagroups[18.6%(8/43)VS.2.9%(1/34)and2.6%(1/39),=8.649,P=0.013;P=0.000;and尸_lt;0.05,respectively].ConclusionOralcontraceptiveorlevonorgestrel—releasingintrauterinesystematefrhysteroscopyforendometrialpolypssigniicfantlydecreasesrecurrencerateandadversereaction,andwerecommendittobewidelyused.【KeyWords】Endometriumpolyp;Hysteroscopy;Combinedoralcontraceptive;Levonorgestrel—releasingintrauterinesystem子宫内膜息肉(endometrialpolyps,EP)是妇女常见的子宫内膜病变，临床表现主要为月经过多、经间期出血、月经淋漓不净或不规则阴道出血，部分患者没有任何临床症状只在超声检查时发现。EP+通讯作者。E-mail:w_ydg2007@126.conr
