子宫内膜不典型增生患者孕激素治疗12例临床疗效分析

Analysis on the Outcome of Conservative Treatment of 12 Young Women with Atypical Endometrial Hyperplasia

【目的】探讨40岁以下中至重度子宫内膜不典型增生患者采用孕激素治疗的疗效。【方法】采用回顾性分析的方法对2000-2007年在怀化市妇女儿童医院收治的40岁以下、接受孕激素治疗（醋酸甲地孕酮）的12例中至重度子宫内膜不典型增生患者的临床病理资料进行研究。其中子宫内膜中至重度不典型增生8例,重度不典型增生4例。孕激素治疗前对患者进行全面分期评估,治疗后3个月宫腔镜评价疗效。【结果】除1例病检证实为子宫内膜样癌外,中至重度和重度不典型增生有效者分别为4例（4/8）、3例（3/4）;缓解者分别为4例（4/8）、1例（1/4）。【结论】对于子宫内膜中至中度不典型增生的要求保留子宫的年轻患者,孕激素治疗是一种可行的治疗选择。

[Objective]To evaluate the effect of hormonal therapy on atypical endometrial hyperplasia in young women aged below 40 years. [Methods] We retrospectively studied the clinical characteristics of 12 patients under 40 years of age diagnosed with atypical endometrial hyperplasia, who were treated with progestin in Huaihua MCH Hospital from 2000 to 2007. According to pathologic results, 12 patients were divided into two groups, i.e. moderate to severe group with 8 cases and severe group with 4 cases. Pelvic ultrasound was used in pretreatment evaluation and hysteroscope was used in effect evaluation after 3 months. [Results] Four cases（4/8） in moderate to severe group and three cases（3/4） in severe group responded to treatment. Among them, four cases（4/8） and one cases（I/4） had complete response. [Conclusion] Progestin therapy is a good choice for young women who have desires of fertility and are diagnosed as severe atypical endometrial hyperplasia.