Clinical Observation On Prevention Of Recurrence Of Endometrial Polyps By Hormone After TCRP Operation

Objective: Through a retrospective collection of 104 patients with AUB who underwent TCRP and pathologically confirmed EPs in the First Affiliated Hospital of Hebei North University.Follow up closely the process of their diagnosis and treatment.The diagnosis and treatment effect of combined use of hormone after TCRP to prevent its recurrence was analyzed,Strengthen the long-term management of EPs,So as to better reduce the probability of EPs happening again.Methods: From January 2017 to January 2019,the clinical data of 104 patients with AUB who underwent TCRP and pathologically confirmed as EPs in the first affiliated Hospital of Hebei North University were selected as the target of the study.These patients underwent four different treatments.Group A was the control group,treated with TCRP alone(25cases).Group B was treated with intrauterine placement of LNG-IUS After operation(23 cases).The other two groups received regular oral medication after surgery,The patienswho oral dydrogesterone tabletswere divided into group C(n = 27);The last group was divided into group D(n = 29),Oral desogestrel and Ethinylestradiol tabletstablets were given for treatment.The patients were followed up for 2 years by outpatient service and telephone after operation.The follow-up included endometrial thickness,AUB improvement,EPs recurrence,adverse reactions and so on.The follow-up deadline was January 2021.Establish database,record summary patients all information,including the basic situation of four groups of patients,record the number of EPs,also need to recod endometrial thickness during the follow-up period,the improvement of AUB and the recurrence of EPs in the follow-up patients.Finally,comprehensive analysis TCRP postoperative combined drug therapy to prevent its recurrence of clinical efficacy observation.Results:the four groups were comparable in endometrial thickness,AUB improvement,EPs recurrence,and adverse reactions.Endometrial thickness: Four groups of patients who were followed up half a year and 1 year after operation were lower than preoperative,the difference is statistically significant(P<0.05);Group B,C and D were lower than group A(P < 0.05).One year after operation,group B was lower than group C and D(P < 0.05).As for the results of postoperative follow-up 2 years,B,C and D groups were lower than those before surgery(P < 0.05),There was no significant difference between group A and pre-operation(P > 0.05).Group B was lower than group A,C and D(P <0.05).C,D group were no significant difference compared with group A(P > 0.05).Group C compared with group D there was no significant difference(P > 0.05).AUB improvement: According to the results of postoperative follow-up for half A year and one year,the improvement rate of AUB in group B was higher than that in group A(P < 0.05).There was no significant difference in AUB improvement rate between group C and group D compared with group A(P > 0.05).There was no significant difference between C group and D group(P>0.05).There was no significant difference in the improvement rate between the C,D groups(P>0.05).The results of 2 years follow-up showed that the improvement rate of AUB in B group was higher than that in A group,C group and D group(0.05).There was no statistical difference in AUB improvement rate between group C and group D compared with group A(P> 0.05).There was no significant difference in AUB improvement rate between group C and group D(P> 0.05).EPs recurrence: According to the results of the six-month follow-up after surgery,there were 2 cases(8.00%),0 cases(0%),1 case(3.70%)and1 case(3.45%)of patients in group A,group B,group C and group D suffering from EPs again,respectively.According to the results of 1-year follow-up after surgery,4 cases(16.00%),0 cases(0%),2 cases(7.40%)and 3 cases(10.34%)of patients in group A,B,C and D suffered EPs again,respectively.After 2 years of follow-up,9 patients(36.00%),1 patient(4.35%),4 patients(14.81%),and 5 patients(17.24%)in group A,B,C,and D developed EPs again,respectively.Through the above results,it was found that the efficacy of three administration groups B,C and D were better than group A,EPs recurrence rate was lower than A group.The recurrence rate EPs B group decreased significantly compared with A group(P<0.05).Adverse Reactions: The incidence of adverse reactions in group B,C and D was 4.35%,29.63% and 31.03%,respectively.C 、 D group was significantly higher than B group(P<0.05),but there was no significant difference between the C group and the D group(P<0.05).Conclusion:1.TCRP can treat EPs effectively,the AUB symptoms of the patients after operation can be improved,the endometrium becomes thinner,but the recurrence rate is higher,and the recurrence rate of 2 years after operation can reach 36.00%.2.Postoperative combination with LNG-IUS,dydrogesterone or deoxyprogesterone Ethinylestradiol tablets can thin the endometrium,further improve the AUB of patients,and reduce the trend of EPs recurrence.3.Intrauterine LNG-IUS implantation after TCRP has more ideal clinical treatment effect,with significantly improved AUB and significantly thinner endometrium,less adverse reactions occurred during follow-up,which can significantly reduce the recurrence rate of EPS.Therefore,it is recommended to be the first choice of adjuvant treatment after TCRP.