宫腔镜在保留生育功能的Ia期子宫内膜癌治疗中的应用

Application value of hysteroscopy in the treatment for early endometrial carcinoma with fertility preservation

目的 探讨宫腔镜在保留生育功能的Ia期子宫内膜癌治疗中的应用价值.方法 回顾性分析了本院2010年1月至2016年1月共计6年收治的Ia期子宫内膜癌有生育要求的患者40例,分为对照组和观察组,各20例,均接受药物保守治疗后对照组行分段诊断术、观察组行宫腔镜下定位活检术,比较两组的术后疗效、宫腔粘连情况及妊娠结局.结果 两组患者术后疗效无明显差异,其复发率均为25.0％,术后6、12个月观察组的宫腔粘连发生率明显低于对照组,差异有统计学意义（P＜0.05）;与对照组比较,观察组术后妊娠率显著提高（66.6％比28.5％）,差异有统计学意义（P=0.04）.结论 采用宫腔镜下定位活检术在Ia期子宫内膜癌保守治疗中不仅确保临床疗效,同时降低宫腔粘连率,能最大限度保护患者的生育能力、预后较佳.

Objective To explore the application value of hysteroscopy in the treatment for early endometrial carcinoma with fertility preservation.Methods 40 cases of early endometrial carcinoma with fertility preservation in our hospital from January 2010 to January 2016 were divided into the control group and the observation group,20 patients in each group.Both two groups received the conservative treatment of the drug.The control group received conventional curettage diagnosis,the observation group received needle localization biopsy and curettage under hysteroscopy.The postoperative curative effect,uterine adhesion,and pregnancy outcomes were compared between the two groups.Results There was no statistically significant difference in the postoperative curative effect between the two groups,the recurrence rate was 25.0% in both two groups.The rate of intrauterine adhesion in the observation group was lower than that in the control group 6,12 months after the surgery,with statistically significant differences （P〈0.05）.The pregnancy rate in the observation group was significantly higher than that in the control group （66.6% vs.28.5%） （P=0.04）.Conclusion Needle localization biopsy under hysteroscopy in the conservative treatment for early endometrial carcinoma can improve the efficacy,protect the patients＇ fertility to maximum limit,with lower intrauterine adhesion rate and good prognosis,worthy of clinical application.