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宫腔镜术后孕激素激素疗法治疗子宫内膜息肉

Post hysteroscopic progesterone hormone therapy in the treatment of endometrial polyps.

作者信息

Li Fangfang, Wei Shuangyan, Yang Shuye, Liu Zhiqiang, Nan Fangfang

机构信息

Fangfang Li, Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, Binzhou, 256603, China.

Shuangyan Wei, Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, Binzhou, 256603, China.

出版信息

Pak J Med Sci. 2018 Sep-Oct;34(5):1267-1271. doi: 10.12669/pjms.345.15330.

Abstract

OBJECTIVE

To find out the clinical effects of post hysteroscopic progesterone hormone therapy in the treatment of endometrial polyps in terms of clinical outcome and the expression of endometrial Vascular Endothelial Growth Factor (VEGF).

METHODS

Ninety-eight patients who were confirmed as endometrial polyp in the hospital from April 2014 and December 2016 were selected and divided into treatment group and a control group using random number table, 49 in each group. Patients in both groups were given hysteroscopic operation. Patients in the treatment group were treated by progesterone hormone drugs after hysteroscopic operation, while patients in the control group were not given progesterone hormone. The changes of menstrual blood volume, menstrual cycle and expression of VEGF were compared between the two groups after treatment, and the recurrence condition, thickness of endometrium and hemoglobin were followed up one year after treatment.

RESULTS

The pictorial blood loss assessment chart (PBAC) scores of patients in the two groups had no significant difference before treatment (P>0.05); but the score of the treatment group was much lower than that of the control group. The improvement rate of menstrual cycle of the treatment group was much higher than that of the control group, and the difference had statistical significance (P<0.05). Compared to before treatment, the serum VEGF level of the patients in both groups had a remarkable decline in the 1, 3 and 6 month after treatment, and the difference had statistical significance (P<0.05). The difference of the serum VEGF level between the two groups in the 1 and 3 month after treatment had no statistical significance (P>0.05). The serum VEGF level of the treatment group was notably lower than that of the control group six months after treatment, and the difference had statistical significance (P<0.05). The follow-up results demonstrated that the treatment group had smaller thickness of endometrium and higher level of hemoglobin compared to the control group, and the recurrence rate of the treatment group was lower than that of the control group (P<0.05).

CONCLUSION

Post hysteroscopic progesterone hormone therapy has favorable clinical effect in treating endometrial polyps as it can effectively prevent the recurrence of endometrial polyps, relieve the level of hemoglobin and reduce endometrial thickness.

摘要

目的

从临床疗效及子宫内膜血管内皮生长因子(VEGF)表达方面探究宫腔镜术后孕激素治疗子宫内膜息肉的临床效果。

方法

选取2014年4月至2016年12月在本院确诊为子宫内膜息肉的98例患者,采用随机数字表法分为治疗组和对照组,每组49例。两组患者均行宫腔镜手术。治疗组患者术后采用孕激素药物治疗,对照组患者术后未给予孕激素。比较两组治疗后月经量、月经周期变化及VEGF表达情况,并在治疗后1年随访复发情况、子宫内膜厚度及血红蛋白水平。

结果

两组患者治疗前图像失血评估图(PBAC)评分比较,差异无统计学意义(P>0.05);但治疗组评分明显低于对照组。治疗组月经周期改善率明显高于对照组,差异有统计学意义(P<0.05)。与治疗前比较,两组患者治疗后1、3、6个月血清VEGF水平均显著下降,差异有统计学意义(P<0.05)。治疗后1、3个月两组血清VEGF水平比较,差异无统计学意义(P>0.05)。治疗后6个月治疗组血清VEGF水平明显低于对照组,差异有统计学意义(P<0.05)。随访结果显示,治疗组子宫内膜厚度小于对照组,血红蛋白水平高于对照组,治疗组复发率低于对照组(P<0.05)。

结论

宫腔镜术后孕激素治疗子宫内膜息肉临床效果良好,可有效预防子宫内膜息肉复发,缓解血红蛋白水平,降低子宫内膜厚度。

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