地屈孕酮联合宫腔镜电切治疗早期子宫内膜癌30例及对生育功能的影响

Dydrogesterone Combined with Hysteroscopic for Treating Early Endometrial Carcinoma and Its Influence on Reproductive Function in 30 Cases

目的观察地屈孕酮联合宫腔镜电切治疗早期子宫内膜癌的疗效及对生育功能的影响。方法选择2008年2月至2011年2月收治的早期子宫内膜癌患者60例，随机分为观察组和对照组，各30例。对照组患者口服醋酸甲地孕酮，观察组患者采用地屈孕酮联合宫腔镜电切疗法。结果观察组总缓解率为83．33％，高于对照组的70．00％（P〈0．05）；术后1年，观察组血清CA125水平显著低于对照组（P〈0．05），1年内复发率为3．33％，显著低于对照组的13．33％（P〈0．05）；与对照组比较，观察组术后2～4年成功受孕率、足月率显著提高，流产率、早产率显著降低（P〈0．05）；两组患者恶心、体重增加及皮疹等不良反应的发生率相当（P〉0．05）。结论采用口服地屈孕酮联合宫腔镜电切治疗早期子宫内膜癌，可显著提高临床疗效，且复发率低，能最大限度保护患者的生育能力，预后较佳，且不良反应较少，值得临床推广。

Objective To observe the effect of dydrogesterone combined with hysteroscopic in treating early endometrial carcinoma, and its influence on reproductive function. Methods 60 cases of early endometrial carcinoma patients from February 2010 to February 2010 were randomly divided into the observation group and the control group, 30 cases in each group. The control group received megestrol acetate therapy, the observation group received dydrogesterone combined with hysteroscopic. The clinical efficacies of the two groups were compared, and the intraoperative complications were recorded; the serum CA125 （carbohydrate antigen 125） level, the recurrence rate and pregnancy postoperative 2-4 years were recorded; the adverse reactions were observed during treatment. Results The total remission rate of the observation group was 83.33%, which was higher than 70. 00% of the control group（ P 〈 0.05）; the serum CA125 level of the observation group was significantly lower than that of control group; the recurrence rate of the observation group was 13.33%, which was significantly lower than 3.33% of control group（P 〈 0.05）; and two, the difference was statistically significant（ P 〈 0.05）. Compared with the control group, the successful pregnancy rate and term rate of the observation group were significantly increased, and the abortion rate and preterm birth rate of the observation group were significantly lower（P 〈 0.05）; the adverse reactions such as nausea, weight gain and skin rashes and others had no statistically significant difference between the two group（ P 〉 0. 05）. Conclusion Dydrogesterone combined with hysteroscopic in treating early endometrial carcinoma can improve the efficacy with lower recurrence rate, can maximum limit to protect the patient＇s fertility, the prognosis is good, and is worth of clinical promotion.