宫腔镜下子宫内膜息肉切除术后不同孕激素 治疗方案及剂量与复发风险的相关性研究

Research on Association between Different Postoperative Progestin Regimens and Dosages and Recurrence Risk after Hysteroscopic Resection of Endometrial Polyps

摘要: 目的：探讨子宫内膜息肉术后不同药物治疗方案及剂量与复发风险之间的关系，为临床术后辅助治疗提供参考。方法：回顾性分析深圳前海蛇口自贸区医院2023年1月至2026年1月行宫腔镜下子宫内膜息肉切除术的80例患者临床资料。根据随访结果分为复发组(n = 9)和未复发组(n = 71)。比较两组年龄、体重指数(BMI)、术前子宫内膜厚度、息肉大小、病程、术前血红蛋白水平及术后药物治疗方案和剂量分组等指标的差异。计量资料采用独立样本t检验，计数资料采用χ²检验或Fisher精确检验。采用单因素Logistic回归分析治疗方案与复发风险之间的关系。结果：80例患者中复发9例，复发率为11.3%。复发与未复发在年龄、BMI、术前子宫内膜厚度、息肉大小、病程及血红蛋白水平方面差异均无统计学意义(均P > 0.05)。不同治疗方案复发率比较差异无统计学意义(Fisher精确检验，P > 0.05)。结论：本研究未发现不同药物治疗方案及剂量与子宫内膜息肉术后复发风险存在显著相关性。由于样本量及复发事件数有限，仍需进一步开展大样本前瞻性研究加以验证。

Abstract: Objective: To investigate the association between different postoperative medical treatment regimens and dosages and the recurrence risk of endometrial polyps after hysteroscopic resection, and to provide evidence for postoperative management. Methods: A retrospective analysis was conducted on 80 patients who underwent hysteroscopic endometrial polypectomy in Qianhai shekou freezone hospital from January 2023 to January 2026. According to follow-up results, patients were divided into a recurrence group (n = 9) and a non-recurrence group (n = 71). Clinical characteristics including age, body mass index (BMI), preoperative endometrial thickness, polyp size, disease duration, hemoglobin level, as well as postoperative treatment regimens and dosage categories were compared between the two groups. Continuous variables were analyzed using the independent-samples t test, and categorical variables were compared using the chi-square test or Fisher’s exact test. Univariate logistic regression analysis was performed to evaluate the association between treatment regimens and recurrence risk. Results: Among the 80 patients, 9 cases experienced recurrence, with an overall recurrence rate of 11.3%. No significant differences were observed between the recurrence and non-recurrence groups in terms of age, BMI, preoperative endometrial thickness, polyp size, disease duration, or hemoglobin level (all P > 0.05). The recurrence rates did not differ significantly among different postoperative treatment regimens (Fisher’s exact test, P > 0.05). Conclusion: This study did not demonstrate a significant association between different postoperative medical treatment regimens or dosages and the recurrence risk of endometrial polyps. Further large-scale prospective studies are warranted to clarify the potential role of postoperative medical therapy in preventing recurrence.