现代妇产科进展Issue(6)：427-431,5.DOI:10.13283/j.cnki.xdfckjz.2014.06.003
子宫内膜增殖症保守治疗的疗效观察
Efficacy of different therapies in treatment of endometrial hyperplasia
摘要
Abstract
Objective:To evaluate the efficacy and safety of different conservative treat-ments in women with endometrial hyperplasia. Methods:116 women younger than 50 years old, diagnosed with complex hyperplasia( CH) in Qilu Hospital of Shandong University from January 2009 to December 2012 by pathologic result were divided into three groups randomly and trea-ted by progestins ( group A) ,COCs ( group B) or LNG-IUS ( group C) . 90 women with atypical hyperplasia ( AH ) were treated by progestins or GnRH-a separately. All patients underwent pathologic examination and adverse effects of drugs were recorded every 3 months since the be-ginning of treatment. Results:( 1 ) Patients with CH:pathologic complete remission rate in the 6th month of each group were 77. 5%(group A)、73. 7%(group B)、94. 7%(group C) (P=0 . 039 ) . There were statistically significant differences among these three groups in uterine breakthrough bleeding ( P=0 . 023 ) and weight gain ( P=0 . 001 ) , but not in gastrointestinal symptoms(P=0. 624). (2) Patients with AH:the pathologic complete remission rate after 6 months' treatment were 70. 5% and 60. 9% (P=0. 197). During treatment,weight gain were reported by 26(59. 1%) out of 44 patients,other adverse effects happened in patients treated by progestins included uterine breakthrough bleeding ( 22 . 7%) , nausea ( 13 . 6%) and fatigue (6. 8%). The most common side-effect of GnRH-a was hot flush(67. 4%),vaginal atrophy (34. 8%),psychological changes(32. 6%) and headaches(10. 9%). None of these patients had adverse effects of vein thrombosis and liver dysfunctions. Conclusions:LNG-IUS could be the best choice for patients with CH under 50 years old. While on the other hand,hysterectomy should be recommended to patients with AH. Both progestins and GnRH-a are considerable op-tions to those who chose conservative treatments,which should be taken under severe surveil-lance.关键词
子宫内膜增殖症/治疗/孕激素/口服避孕药/LNG-IUS/GnRH-aKey words
Endometrial hyperplasia/Treatment/Progestin/Oral contraceptives/Levonorgestrel-releasing intrauterine system ( LNG-IUS )/Gonadotropin-releasing hormone ana-logues( GnRH-a)分类
医药卫生引用本文复制引用
孙清,杨兴升,李玲,何淼龙,吴倩,王秀珍..子宫内膜增殖症保守治疗的疗效观察[J].现代妇产科进展,2014,(6):427-431,5.基金项目
卫生行业科研专项(No:201002013) （No:201002013）
