醋酸甲地孕酮治疗早期高分化子宫内膜样腺癌保留生育功能的可行性及安全性

Feasibility and safety of megestrol acetate in the treatment of early differentiated endometrial adenocarcinoma to retain the feasibility

目的探讨醋酸甲地孕酮治疗早期高分化子宫内膜样腺癌保留生育功能的可行性及安全性。方法选取2013年5月至2015年3月间临朐县人民医院收治的120例早期高分化子宫内膜样腺癌的患者作为研究对象,采取随机数字表法分为试验组与对照组,每组60例。试验组患者采用常规化疗法加用醋酸甲地孕酮,对照组患者采用单纯常规化疗法。对两组患者不同病理学类型治疗后的诊断性刮宫结果,胃肠道反应、脊髓抑制、便血等发生率以及受孕后成功分娩率进行比较。结果试验组患者鳞状化生、嗜酸性化生、黏液性化生和不伴化生有效率均高于对照组,差异均有统计学意义(P<0.05)。试验组患者的胃肠道反应、脊髓抑制、便血、心悸、白细胞减低和凝血异常的发生率均低于对照组患者,差异均有统计学意义(均P<0.05)。试验组患者的受孕率、成功分娩率和孕激素水平均高于对照组,差异均有统计学意义(均P<0.05)。试验组患者的流产率及雌激素水平均低于对照组,差异均有统计学意义(均P<0.05)。结论相比于常规化疗,采用醋酸甲地孕酮治疗早期高分化子宫内膜样腺癌的临床疗效较好,生育功能保存良好,安全性较高,可作为一种理想方法应用于临床工作中。

Objective To explore and analyze safety and security of megestrol acetate in the treatment of early differentiated endometrial adenocarcinoma to retain the feasibility. Methods From May 2013 to March 2015 in People＇s Hospital of Linqu County,120 cases of early differentiated endometrial adenocarcinoma patients were selected and divided into the experimental group and the control group,with 60 cases in each group. Patients in the experimental group received routine therapy combined with megestrol acetate,and patients in the control group received the routine therapy only. The results of diagnostic curettage,incidence of gastrointestinal reaction,inhibition in the spinal cord and hematochezia,successful delivery rate after conception of two groups were compared. Results The efficiency of squamous metaplasia,eosinophilic metaplasia,mucous metaplasia,and the non-associated metaplasia of experimental group were higher than those in control group,with statistical difference（ P 〈0. 05）. The incidence of gastrointestinal tract reaction,inhibition in the spinal cord,hematochezia,palpitations,leukopenia and coagulation abnormalities were lower than those in the control group,with statistical difference（ P〈 0. 05）. The pregnant rate,success rate of delivery,and progesterone level in the experimental group were higher than those in the control group,with statistical difference（ P 〈0. 05）. The abortion rate and estrogen level in the experimental group were lower than those in the control group,with statistical difference（ P 〈0. 05）. Conclusions Clinical curative effect of megestrol acetate in the treatment of early differentiated endometrial adenocarcinoma is prominent,reproductive function was well preserved. It is worth clinical promotion.