摘要
目的分析曼月乐放置时机对宫腔镜子宫内膜息肉电切术后临床效果及安全性的影响。方法本研究属历史性队列研究,选取武汉市江夏区第一人民医院2022年1月至2023年12月收治的子宫内膜息肉并经宫腔镜电切术治疗者120例,按照患者术后曼月乐的放置时机分为即时组65例(术中放置曼月乐)和延迟组55例(术后初次月经3~7 d放置曼月乐)。比较两组症状改善、阴道流血、月经情况及不良反应等。结果相较于术前,两组术后3、6个月时的月经经期时长、月经周期、月经失血图(PBAC)评分及子宫内膜厚度显著降低,血红蛋白(Hb)含量增加,性生活状态均改善,差异有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05)。即时组术后6个月时的阴道点滴出血率(27.69%)低于延迟组(50.91%)(P<0.05),而其他不良反应以及术后复发情况比较差异无统计学意义(P>0.05)。结论对宫腔镜子宫内膜息肉电切术患者采用曼月乐放置治疗,可改善患者月经状况,提高血红蛋白水平,其效果不受曼月乐放置时机的影响,术中放置曼月乐可降低术后阴道点滴出血率。
Objective To analyze the efficacy of levonorgestrel-releasing intrauterine system(LNG-IUS,Mirena)plalement time on the clinical effect and safety of hysteroscopic endometrial polyp eleltrocision.Methods This study was a historical cohort study,120 patients with endometrial polyps treated with hysteroscopic polypectomy at the First Peoples Hospital of Jiangxia District from January 2022 to December 2023 were selected,they were divided into an immediate group(n=65,intraoperative LNG-IUS insertion)and a delayed group(n=55,LNG-IUS insertion 3~7 days after the first postoperative menstruation).Symptom improvement,vaginal bleeding,menstrual patterns,and adverse events were compared between the two groups.Results sAt 3 and 6 months postoperatively,both groups showed significant reductions in menstrual duration,menstrual cycle length,pictorial blood loss assessment chart(PBAC)scores,and endometrial thickness,along with increased hemoglobin(Hb)levels and improved sexual function(all P<0.05),with no significant intergroup differences(P>0.05).The immediate group had a lower rate of postmenopausal spoting(27.69%vs.50.91%,P<0.05)at 6 months,while other adverse events and recurrence rates showed no significant differences(P>0.05).Conclusion LNG-IUS insertion after hysteroscopic polypectomy improves menstrual outcomes and hemoglobin levels,with no significant impact from insertion timing.Intraoperative LNG-IUS placement may reduce postoperative spotting incidence.
作者
郑丽芳
段丽君
Zheng Lifang;Duan Lijun(Department of Gynecology,the First Peoples Hospital of Jiangxia District,Wuhan Hubei 430200,P.R.China)
出处
《中国计划生育和妇产科》
2025年第7期67-71,共5页
Chinese Journal of Family Planning & Gynecotokology
关键词
宫腔镜
子宫内膜息肉
时机
曼月乐
hysteroscopy
endometrial polyps
timing
levonorgestrel-releasing intrauterine system(Mirena)
