Clinical Study on Transcervical Resection of Polyp Combined with Levonorgestrel-Releasing Intrauterine System in the Treatment of Endometrial Polyps

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doi:10.3877/cma.j.issn.1673-5250.2014.04.022

Objective

To explore the clinical value of the levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of endometrial polyps (EP) after transcervical resection of polyp (TCRP).

Methods

From July 2010 to July 2011, a total of 92 EP patients after TCRP surgery in Baoji Central Hospital were included. In accordance with the order of admission, they were randomly divided into research group(n = 46, TCRP + LNG-IUS) and control group(n = 46, TCRP). The menstrual blood volume [pictorial blood loss assessment chart (PBAC) score], endometrial thickness, hemoglobin level and EP recurrence rate were compared between two groups, and the adverse reactions of research group were observed at the same time. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Baoji Central Hospital. Informed consent was obtained from each patient. There were no significant difference in age, clinical symptoms and other general conditions between two groups (P>0.05).

Results

The results were:①The menstrual blood volume (PBAC score) of research group decreased significantly compared with that of control group in 3,9,12,18,24 months follow-up(t = 3.12,4.12,4.14,4.67,4.76; P<0.01); ②The endometrial thickness of research group were significantly thinner than that of control group in 9,12, 18,24 months follow-up(t=2.55,2.68,2.89,3.12; P<0.05);③Hemoglobin levels of research group were significantly higher than that of control group in 3,9,12,18,24 months follow-up(t= 1.02,2.10,2.41, 2.56,2.76; P< 0.05);④The EP recurrence rate of research group was significantly lower than that of control group (0 vs. 23.9%) in 2-year follow up(χ² =12.32,P=0.004).

Conclusions

In the treatment of EP, TCPR combined with LNG-IUS can effectively alleviate menorrhagia, reduce endometrial thickness, recover hemoglobin level and reduce EP recurrence rate.

Key words: Endometrium, Polyps, Hysteroscopes, Levonorgestrel

表1 两组月经量PBAC评分随访结果比较(分，±s)

Table 1 Comparison of the menstrual blood volume PBAC score between two groups (score, ±s)

组别	n	第3个月	第9个月	第12个月	第18个月	第24个月
研究组	46	39.20±11.90	15.46±12.40	12.40±10.90	11.20±9.60	10.60±8.60
对照组	46	74.20±14.90	69.46±12.40	70.40±10.90	79.20±9.60	82.60±9.70
t		3.12	4.12	4.14	4.67	4.76
P		0.009	0.008	0.008	0.006	0.004

表1 两组月经量PBAC评分随访结果比较(分，±s)

Table 1 Comparison of the menstrual blood volume PBAC score between two groups (score, ±s)

组别	n	第3个月	第9个月	第12个月	第18个月	第24个月
研究组	46	39.20±11.90	15.46±12.40	12.40±10.90	11.20±9.60	10.60±8.60
对照组	46	74.20±14.90	69.46±12.40	70.40±10.90	79.20±9.60	82.60±9.70
t		3.12	4.12	4.14	4.67	4.76
P		0.009	0.008	0.008	0.006	0.004

表2 两组子宫内膜厚度随访结果比较(cm，±s)

Table 2 Comparison of endometrial thickness between two groups (cm, ±s)

组别	n	第3个月	第9个月	第12个月	第18个月	第24个月
研究组	46	0.39±0.65	0.22±0.51	0.26±0.41	0.21±0.32	0.22±0.24
对照组	46	0.40±0.35	0.38±0.33	0.41±0.26	0.37±0.22	0.42±0.44
t		1.82	2.55	2.68	2.89	3.12
P		0.058	0.047	0.042	0.032	0.016

表2 两组子宫内膜厚度随访结果比较(cm，±s)

Table 2 Comparison of endometrial thickness between two groups (cm, ±s)

组别	n	第3个月	第9个月	第12个月	第18个月	第24个月
研究组	46	0.39±0.65	0.22±0.51	0.26±0.41	0.21±0.32	0.22±0.24
对照组	46	0.40±0.35	0.38±0.33	0.41±0.26	0.37±0.22	0.42±0.44
t		1.82	2.55	2.68	2.89	3.12
P		0.058	0.047	0.042	0.032	0.016

表3 两组贫血患者血红蛋白水平随访结果比较(g/L，±s)

Table 3 Comparison of hemoglobin levels between two groups (g/L, ±s)

组别	n	第3个月	第9个月	第12个月	第18个月	第24个月
研究组	33	96.40±10.20	116.30±11.40	124.60±8.20	131.10±10.60	134.20±9.80
对照组	33	97.40±13.20	101.30±14.40	112.60±16.20	104.10±15.60	100.20±16.80
t		1.02	2.10	2.41	2.56	2.76
P		0.020	0.015	0.012	0.008	0.007

表3 两组贫血患者血红蛋白水平随访结果比较(g/L，±s)

Table 3 Comparison of hemoglobin levels between two groups (g/L, ±s)

组别	n	第3个月	第9个月	第12个月	第18个月	第24个月
研究组	33	96.40±10.20	116.30±11.40	124.60±8.20	131.10±10.60	134.20±9.80
对照组	33	97.40±13.20	101.30±14.40	112.60±16.20	104.10±15.60	100.20±16.80
t		1.02	2.10	2.41	2.56	2.76
P		0.020	0.015	0.012	0.008	0.007

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