地屈孕酮联合宫腔镜电切术治疗保留生育功能早期子宫内膜癌患者的效果

Effect of dydrogesterone combined with hysteroscopic electrotomy in the treatment of early endometrial carcinoma patients with fertility preservation

目的探讨地屈孕酮联合宫腔镜电切术治疗保留生育功能早期子宫内膜癌患者的效果。方法根据治疗方式的不同将112例早期子宫内膜癌患者分为对照组(n=50,宫腔镜电切术)和观察组(n=62,宫腔镜电切术联合地屈孕酮),比较两组患者的性激素[雌二醇(E2)、黄体生成素(LH)]水平、性功能[女性性功能指数(FSFI)]、生育能力[子宫内膜异位症生育指数(EFI)]及不良反应发生情况。结果治疗后,两组患者血清E2、LH水平和FSFI各维度评分均高于本组治疗前,观察组患者血清E2、LH水平和FSFI各维度评分均高于对照组,EFI评分5~7分患者比例高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的不良反应总发生率明显低于对照组,差异有统计学意义(P﹤0.01)。结论地屈孕酮联合宫腔镜电切术可提高保留生育功能早期子宫内膜癌患者的性激素水平、生育能力及性功能,并且不良反应发生率较低。

Objective To investigate the effect of dydrogesterone combined with hysteroscopic electrotomy in the treatment of early endometrial carcinoma patients with fertility preservation.Method A total of 112 patients with early endometrial carcinoma were divided into control group(n=50,hysteroscopic electrotomy)and observation group(n=62,hysteroscopic electrotomy combined with dydrogesterone)according to different treatment methods.The sex hormones[estradiol(E2),luteinizing hormone(LH)]levels,sexual function[female sexual function index(FSFI)],fertility[endometriosis fertility index(EFI)]and incidence of adverse reactions were comapred between the two groups.Result After treatment,the serum E2,LH levels and the dimensional scores of FSFI in two groups were higher than those before treatment,the serum E2,LH levels and the dimensional scores of FSFI in observation group were higher than those in control group,the proportion of patients with EFI score of 5 to 7 points was higher than that in control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in observation group was significantly lower than that in control group,and the difference was statistically significant(P<0.01).Conclusion Dydrogesterone combined with hysteroscopic electrotomy in the treatment of early endometrial carcinoma patients with fertility preservation can improve the levels of sex hormones,fertility and sexual function,and the incidence of adverse reactions is low.