甲羟孕酮对年轻子宫内膜不典型增生患者的疗效研究

Clinical Study of Medroxyprogesterone in the Treatment of Young Patients with Endometrial Atypical Hyperplasia

目的探讨甲羟孕酮对年轻子宫内膜不典型增生患者的疗效。方法 115例子宫内膜不典型增生患者,轻度、中度和重度不典型增生分别为63、32和20例。所有患者经诊断性刮宫病理检查确诊,应用甲羟孕酮治疗3～6个月后,行诊刮送病理检查以评价其疗效,记录有生育要求患者妊娠情况。结果 115例患者经甲羟孕酮治疗后,109例有效,总有效率达94.7%,轻度、中度和重度子宫内膜不典型增生患者有效率分别为100.0%、93.7%和70.0%,轻度和中度患者总有效率显著高于重度患者,差异有统计学意义(P<0.05)。95例有生育要求的患者治疗后64例达临床妊娠,其中轻度患者42例,中度患者15例,重度患者7例,轻度、中度和重度患者妊娠率分别为73.6%、60.0%和53.8%,三组妊娠率比较无统计学差异(P>0.05)。结论对有生育要求的年轻子宫内膜不典型增生患者,采用甲羟孕酮保守治疗的效果好,不仅能够有效治疗疾病,而且能够提高患者生活质量,达到生育目的,但要注意密切随访预防复发。

Objective To study the effects of medroxyprogesterone in young patients with endometrial hyperplasia.Methods 115 patients with endometrial hyperplasia were divided into mild,moderate and severe hyperplasia with 63,32 and 20 cases,respectively.All patients were dignosed and confirmed by pathological examination.The efficacy was evaluated after treatment with medroxyprogesterone for 3-6 months by pathological examination.The pregnancy situation was recorded for patients having fertility requirements.Results There were 109 positive cases in 115 patients after treated by medroxyprogesterone.The total efficiency rate was 94.7%.The efficiency rate in mild,moderate and severe endometrial atypical hyperplasia were 100.0%,93.7% and 70.0% respectively.The positive rates for patients with mild and moderate endometrial hyperplasia were significantly higher than patients with severe endometrial atypical hyperplasia.There was significant difference（P0.05）.64 patients achieved clinical pregnancy after treatment in 95 patients with fertility requirements,including 42 cases in mild,15 cases in moderate and 7 cases in severe hyperplasia.The pregnancy rates for patients with mild,moderate and severe endometrial hyperplasia were 73.6%,60.0% and 53.8% respectively,there was no significant difference（P0.05）.Conclusion Medroxyprogesterone is effective for young patients with endometrial hyperplasia and having pregnancy requirements.Medroxyprogesterone can not only treat the disease effectively,but also improve the quality of patients＇ life and achieve the purpose of reproduction.We should pay close attention to the follow-up to prevent recurrence.