生殖医学杂志

目的 初步探讨地屈孕酮术前预处理对多发性子宫内膜息肉患者行宫腔镜下子宫内膜息肉切除术(TCRP)后息肉复发率及临床疗效的影响。方法 回顾性分析南京医科大学第三附属医院(常州市第二人民医院)2022年1月至2024年6月收治的166例多发性子宫内膜息肉患者的临床资料。根据术前预处理方式不同进行分组：A组(地屈孕酮预处理1个周期者，42例),B组(地屈孕酮预处理2个周期者，28例)及C组(对照组，未进行药物预处理者，96例)。通过临床资料的比较，评价地屈孕酮预处理的治疗效果。结果 3组患者的一般资料比较均无显著性差异(P>0.05)。B组患者的术前子宫内膜厚度显著低于C组[(0.83±0.28)cm vs.(1.06±0.35)cm,P<0.05],A组的术后阴道出血时间显著短于C组[(4.74±1.36)d vs.(5.32±2.00)d,P<0.05]。A组和B组的治疗总有效率显著高于C组(85.71%、100.00%vs. 66.67%,P<0.05);B组的术后息肉复发率显著低于C组(0.00%vs. 13.54%,P<0.05)。结论 TCRP术前地屈孕酮预处理可能在优化多发性子宫内膜息肉患者的治疗中发挥了一定作用，但其远期疗效仍需要进一步研究验证。

Objectives:To preliminary investigate the effect of dydrogesterone pretreatment before transcervical resection of endometrial polyps(TCRP) on the recurrence rate and clinical efficacy in patients with multiple endometrial polyps.Methods:A retrospective analysis was conducted on the clinical data of 166 patients with multiple endometrial polyps admitted to the Third Affiliated Hospital of Nanjing Medical University(Changzhou Second People's Hospital) from January 2022 to June 2024. According to different preoperative pretreatment methods, the patients were divided into three groups: group A(dydrogesterone pretreatment for one cycle, 42 cases),group B(dydrogesterone pretreatment for two cycles, 28 cases),and group C(control group with no pretreatment, 96 cases). The therapeutic effect of progesterone pretreatment was evaluated through clinical data comparison.Results:There was no significant difference in general characteristics among the three groups(P>0.05). The preoperative endometrial thickness in group B was significantly lower than that of group C [(0.83±0.28) cm vs.(1.06±0.35) cm, P<0.05],and the duration of postoperative vaginal bleeding of group A was significantly shorter than that of group C [(4.74±1.36) d vs.(5.32±2.00) d, P<0.05]. The total effective rates of treatment in group A and group B were significantly higher than that in group C(85.71%,100.00% vs. 66.67%,P<0.05). The postoperative polyp recurrence rate in group B was significantly lower than that in group C(0.00% vs. 13.54%,P<0.05).Conclusions:Pretreatment with dydrogesterone before TCRP may play a certain role in optimizing the treatment of patients with multiple endometrial polyps, but its long-term efficacy still needs further research and verification.