子宫内膜增生及早期子宫内膜腺癌行孕激素治疗的临床分析

目的 探讨孕激素治疗早期子宫内膜腺癌(endometrial carcinoma,EC)及子宫内膜增生(endometrial hyperplasia,EH)的临床疗效。 方法 回顾性分析2009年10月~2013年10月期间于笔者医院确诊的96例早期EC和EH患者的临床资料,全部患者均口服孕激素治疗,观察患者在治疗前后月经周期、经期持续时间及子宫内膜厚度等指标的变化;同时,对于有生育要求的51例患者,分析服药后患者妊娠率、生育率、药物不良反应以及疾病复发情况。 结果 与治疗前相比,口服孕激素能够明显延长月经周期(29.1±2.1 vs 23.4±4.9d)、缩短经期持续时间(7.2±2.3 vs 15.7±4.1d)、减少子宫内膜厚度(17.2±1.9 vs 23.7±3.2mm)(P<0.05);口服孕激素治疗后1、2、3个月患者血浆血红蛋白含量与治疗前相比显著提高(100.4±16.1、115.8±18.4、129.3±21.2 vs 83.2±14.9g/L)(P<0.05);51例有生育要求的患者治疗后妊娠率为54.90%,生育率为39.22%;服药后出现肝肾功能异常等毒性不良反应,复发率为11.5%。 结论 治疗早期子宫内膜腺癌或子宫内膜增生,口服孕激素具有较好的临床疗效、纠正患者贫血状态,同时能够保持部分患者的生育能力,但其仍然存在一定的毒性不良反应及复发性,临床应谨慎使用。

Clinical Analysis of Effect of Progestin on Early Endometrial Carcinoma and Endometrial Hyperplasia

Objective To explore the clinical effect of progestin on early endometrial carcinoma (EC)and endometrial hyperplasia (EH). Methods Respective analysis of 96 patients who were diagnosed with early EC or EH in our hospital from October 2009 to October 2013 were made. The menstrual cycle, menstrual duration and endometrial thickness between untreated and treated with progestin were compared. The ratio of fertility for 51 patients who were desired to have babies were studied, and side effects and the rate of recurrence of all patients who were treated with progestin were analyzed. Results After treated with progestin, the menstrual cycle prolonged(29.1±2.1 vs 23.4±4.9 d), the menstrual duration shortened(7.2±2.3 vs 15.7±4.1 d) and the endometrial thickness decreased significantly(17.2±1.9 vs 23.7±3.2 mm) (P<0.05). After treated with progestin, the content of hemoglobin in the first, second and third month increased significantly compared with control (100.4±16.1,115.8±18.4,129.3±21.2 vs 83.2±14.9g/L) (P<0.05), After treated with progestin, the ratio of pregnancy was 54.90% and the ratio of fertility was 39.22%. There existed different levels of side effects, such as liver and kidney dysfunction. The ratio of recurrence was 11.5%. Conclusion For conservative treatment on early EC and EH with progestin, its clinical effect is obvious, which can improve the anemia state. It gives hopes to some patients who desired to have babies, however, its side effect and recurrence still exist, and it should be used with caution in clinical.