宫腔镜腹腔镜手术联合高效孕激素治疗子宫内膜癌患者的临床疗效及保育功能

Clinical efficacy and fertility preservation of hysteroscopy and laparoscopy combined with high-efficiency progestogen in the treatment of patients with endometrial cancer

目的探讨宫腔镜腹腔镜手术联合高效孕激素治疗子宫内膜癌患者的临床疗效及保育功能。方法根据治疗方法的不同将84例要求保留生育功能的子宫内膜癌患者分为观察组和对照组,每组42例。观察组患者予以宫腔镜腹腔镜手术联合高效孕激素治疗,对照组患者予以单纯高效孕激素治疗。比较两组患者的临床疗效及治疗前、治疗后6个月、治疗后12个月的血清癌胚抗原125(CA125)、人附睾蛋白4(HE4)水平和妊娠情况(成功受孕、流产、早产、足月分娩)。结果观察组患者的总有效率为90.48%,明显高于对照组患者的61.90%,差异有统计学意义(P﹤0.01)。治疗前、治疗后6个月、治疗后12个月,两组患者的血清CA125、HE4水平比较,差异均无统计学意义(P﹥0.05)。治疗后6个月、治疗后12个月,两组患者的血清CA125、HE4水平均低于本组治疗前,差异均有统计学意义(P﹤0.05)。观察组患者的成功受孕率和足月分娩率均高于对照组,且流产率和早产率均低于对照组,差异均有统计学意义(P﹤0.05)。结论对子宫内膜癌患者予以宫腔镜腹腔镜手术联合高效孕激素治疗,可在确保其具备适应证的情况下,保留生育功能,提高受孕率及足月分娩率,其临床效果佳。

Objective To analyze the clinical efficacy and fertility preservation of hysteroscopy and laparoscopy combined with high-efficiency progestogen in the treatment of patients with endometrial cancer.Method 84 patients with endometrial cancer requiring to retain fertility were selected and divided into observation group and control group according to treatment methods,with 42 cases in each group.The observation group was treated with hysteroscopy and laparoscopy combined with high-efficiency progestogen,while the control group was treated with high-efficiency progestogen.The clinical efficacy,serum carcinoembryonic antigen 125(CA125)and human epididymis protein 4(HE4)levels before treatment,6 months after treatment,12 months after treatment and pregnancy status(successful conception,miscarriage,premature delivery,full-term delivery)between the two groups were compared.Result The overall response rate in the observation group was significantly higher than that in the control group(90.48%vs 61.90%)(P<0.01).There was no significant difference in the levels of serum CA125 and HE4 between the observation group and the control group before treatment,6 months after treatment and 12 months after treatment(P>0.05);6 months after treatment and 12 months after treatment,the levels of serum CA125 and HE4 in the two groups were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).The rates of successful conception and full-term delivery in the observation group were significantly higher than those in the control group,and the rates of miscarriage and premature delivery were lower than those in the control group(P<0.05).Conclusion Hysteroscopy and laparoscopy combined with high-efficiency progestogen in the treatment of patients with endometrial cancer can ensure that it retains fertility under the condition of indications,and can significantly improve the conception rate and full-term delivery rate.