标题：甲羟孕酮联合TCRP术治疗子宫内膜息肉的疗效及对患者血清VEGF、性激素水平的影响

      作者：郑贺，李玉玲，黄燕萍    连州市妇幼保健计划生育服务中心妇科，广东 清远 513400

      卷次： 2021年32卷9期

      【摘要】 目的 探讨甲羟孕酮联合宫腔镜电切(TCRP)术治疗子宫内膜息肉的疗效及对患者血清血管内皮生长因子(VEGF)和性激素水平的影响。方法 选取连州市妇幼保健计划生育服务中心妇科 2019年 8月至 2020年10月收治的60例子宫内膜息肉患者为研究对象。按照随机数表法将所有患者分为观察组和对照组，每组30例，观察组患者给予甲羟孕酮联合TCRP术治疗，对照组仅使用TCRP术治疗。治疗6个月比较两组患者的子宫内膜厚度、月经量、性激素卵泡刺激素(FSH)和黄体生成素(LH)水平、月经正常率、复发率、并发症发生率，同时比较两组患者术前24h、术后1个月、术后3个月、术后6个月的血清VEGF水平。结果 观察组患者治疗6个月的子宫内膜厚度和月经量分别为(5.56±0.52) mm、(71.48±6.44) mL，明显小(少)于对照组的(7.23±0.83) mm、(100.32±10.83) mL，差异均有统计学意义(P<0.05)；观察组患者治疗后的性激素LH、FSH水平分别为(5.12±0.47) mIU/mL、(5.98±0.54) mIU/mL，明显低于对照组的(6.64±0.93) mIU/mL、(6.84±0.81) mIU/mL，差异均有统计学意义(P<0.05)；观察组患者治疗6个月后的复发率为 3.33%，明显低于对照组的 20.00%，月经正常率为 93.33%，明显高于对照组的 73.33%，差异均有统计学意义(P<0.05)；观察组和对照组患者治疗 6个月后的并发症发生率分别为 3.33%，10.00%，差异无统计学意义(P>0.05)；观察组患者术后 1个月、术后 3个月、术后 6个月的血清VEGF水平分别为(30.27±2.65) ng/L、(40.21±4.53) ng/L、(47.51±5.36) ng/L，明显低于对照组的(38.64±3.78) ng/L、(55.54±6.29) ng/L、(76.56±6.45) ng/L，差异均有统计学意义(P<0.05)。结论 甲羟孕酮联合 TCRP术治疗子宫内膜息肉可抑制患者子宫内膜增生，改善血清VEGF和性激素水平，减少术后复发，安全性高，值得临床推广应用。
      【关键词】 子宫内膜息肉；甲羟孕酮；宫腔镜电切术；血管内皮生长因子；性激素；复发
      【中图分类号】 R711.74 【文献标识码】 A 【文章编号】 1003—6350（2021）09—1140—04

Effect of medroxyprogesterone combined with TCRP in the treatment of endometrial polyps and its influence onserum vascular endothelial growth factor and sex hormone levels.
ZHENG He, LI Yu-ling, HUANG Yan-ping.Department of Gynecology, Lianzhou Maternal and Child Health and Family Planning Service Center, Qingyuan 513400,Guangdong, CHINA
【Abstract】 Objective To investigate the curative effect of medroxyprogesterone combined with hysteroscopicresection (TCRP) in the treatment of endometrial polyps and its influence on serum vascular endothelial growth factor(VEGF) and sex hormone levels. Methods Sixty patients with endometrial polyps in Lianzhou Maternal and ChildHealth and Family Planning Service Center from August 2019 to October 2020 were selected as the research objects. Ac-cording to the random number table method, all patients were divided into the observation group and the control group,with 30 patients in each group. The observation group was treated with medroxyprogesterone combined with TCRP, andthe control group was only treated with TCRP. After 6 months of treatment, the endometrial thickness, menstrual vol-ume, sex hormone follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels, normal menstruation rate, re-currence rate and complication rate of the two groups were compared, and the serum VEGF levels of the two groups 24hours before operation, 1 month after operation, 3 months after operation and 6 months after operation were compared.Results The endometrial thickness and menstrual volume of the observation group after treatment were (5.56±0.52) mmand (71.48±6.44) mL, respectively, which were significantly smaller (less) than (7.23±0.83) mm and (100.32±10.83) mLin the control group (P<0.05); the levels of sex hormones LH and FSH in the observation group after treatment were(5.12±0.47) mIU/mL and (5.98±0.54) mIU/mL, which were significantly lower than (6.64±0.93) mIU/mL and (6.84±0.81) mIU/mL in the control group (P<0.05); the postoperative recurrence rate in the observation group was 3.33% ,which was significantly lower than 20.00% in the control group, and the normal menstrual rate was 93.33%, which wassignificantly higher than 73.33% in the control group, with statistically significant differences (P<0.05). The incidence ofcomplications in the observation group and the control group after 6 months of treatment were 3.33% and 10.00%, re-spectively, and the difference was not statistically significant (P>0.05). The serum VEGF levels of patients in the obser-