地屈孕酮联合宫腔镜电切对保留生育功能的早期子宫内膜癌患者的影响
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摘要
目的探讨地屈孕酮联合宫腔镜电切对保留生育功能的早期子宫内膜癌患者的影响。方法选择2016年1月至2017年10月十堰市妇幼保健院诊治的80例早期子宫内膜癌患者为研究对象,按照随机数字法将其平均分为观察组和对照组,每组40例患者。观察组患者先行宫腔镜电切治疗,随后连续口服地屈孕酮;对照组患者则实施腹腔镜下手术治疗。比较两组患者治疗后生殖相关激素雌二醇(E_2)和促黄体生成素(LH)水平,两组患者性生活质量标准指标量表评分(FSFI)和生育指数EFI评分变化情况,以及不良反应的发生情况。结果术后,观察组患者E_2和LH水平均显著高于对照组患者(均P<0.05);观察组患者FSFI评分分项评分和总分均明显优于对照组患者(均P<0.05);观察组患者5～7分和8～10分两段评分人数占比均高于对照组患者(均P<0.05);观察组患者出现机体潮热、阴道干涩和闭经的占比均显著低于对照组患者(均P<0.05)。结论针对有生育愿望的早期子宫内膜癌患者实施宫腔镜电切治疗,术后服用地屈孕酮,患者术后性功能和生育功能恢复快,并发症少,具有临床推广价值。
Objective To investigate the effects of dydrogesterone combined with hysteroscopic electrotomy on early endometrial cancer patients preserving reproductive function. Methods 80 patients with early endometrial cancer admitted to Shiyan Maternal and Child Health Care Hospital from January 2016 to October 2017 were divided into two groups according to random number method, 40 cases in each group. The observation group was treated with hysteroscopic electrotomy and was given dydrogesterone orally continuously and the control group was treated with laparoscopic surgery. The levels of reproductive-related hormones estradiol(E_2) and luteinizing hormone(LH), changes in the scores of Female Sex Function Index(FSFI) and Female Fertility Index(EFI) and incidence of adverse reactions were compared between the two groups. Results After operation, the levels of E_2 and LH in the observation group were significantly higher than those in the control group(all P<0.05). The scores of each index of FSFI and the total score in the observation group were significantly better than those in the control group(all P<0.05). The proportion of 5-7 and 8-10 scores in the observation group was higher than that in the control group(all P<0.05). The incidences of hot flashes, vaginal dryness and amenorrhea in the observation group were significantly lower than those in the control group(all P<0.05). Conclusions For patients with early stage endometrial cancer who want to preserve reproduction function, hysteroscopic electrotomy combined with progesterone is conductive to the recovery of sexual function and reproduction function, with few complications.
Objective To investigate the effects of dydrogesterone combined with hysteroscopic electrotomy on early endometrial cancer patients preserving reproductive function. Methods 80 patients with early endometrial cancer admitted to Shiyan Maternal and Child Health Care Hospital from January 2016 to October 2017 were divided into two groups according to random number method, 40 cases in each group. The observation group was treated with hysteroscopic electrotomy and was given dydrogesterone orally continuously and the control group was treated with laparoscopic surgery. The levels of reproductive-related hormones estradiol(E_2) and luteinizing hormone(LH), changes in the scores of Female Sex Function Index(FSFI) and Female Fertility Index(EFI) and incidence of adverse reactions were compared between the two groups. Results After operation, the levels of E_2 and LH in the observation group were significantly higher than those in the control group(all P<0.05). The scores of each index of FSFI and the total score in the observation group were significantly better than those in the control group(all P<0.05). The proportion of 5-7 and 8-10 scores in the observation group was higher than that in the control group(all P<0.05). The incidences of hot flashes, vaginal dryness and amenorrhea in the observation group were significantly lower than those in the control group(all P<0.05). Conclusions For patients with early stage endometrial cancer who want to preserve reproduction function, hysteroscopic electrotomy combined with progesterone is conductive to the recovery of sexual function and reproduction function, with few complications.
引文
[1] 江娟,郑超群,钟肇梅.宫腔镜电切术联合口服孕激素及宫内放置LNG-IUS治疗早期子宫内膜癌的效果[J].中国实用医药,2017,12(22):49-50.
[2] Lucic N,Draganovic D,Sibincic S,et al.Myometrium invasion,tumour size and lymphovascular invasion as a prognostic factor in dissemination of pelvic lymphatics at endometrial carcinoma[J].Med Arch,2017,71(5):325-329.
[3] Stachowicz N,Mazurek D,Czekierdowski A.Diagnostic hysteroscopy and the risk of malignant cells intraabdominal spread in women withendometrial cancer[J].Ginekol Pol,2017,88(10):562-567.
[4] 姚广,雷敏,吕晓,等.子宫内膜癌的早期诊断研究进展[J].中国妇幼保健,2018,33(1):235-237.
[5] 朱瑜苑,王刚.左炔诺孕酮宫内缓释系统在子宫内膜癌保留生育功能治疗中的应用[J].中国实用妇科与产科杂志,2017,33(12):1296-1299.
[6] 王妨妨,林俊,于爱军.保留生育功能的宫腔镜手术联合孕激素治疗Ia期子宫内膜癌9例临床分析[J].浙江医学,2017,39(22):2029-2031,2046.
[7] 李品莹,李小毛.子宫内膜癌保留生育功能的研究进展[J].新医学,2017,48(11):753-756.
[8] Zhang R,Gu P,Liu Q,et al.Analysis of diagnosis and treatment of complicated cervical severe adhesion atresia after removal of endometrial stromal nodule:A case report[J].Medicine (Baltimore),2017,96(48):e8979.
[9] Elyashiv O,Sagiv R,Kerner R,et al.Hysterscopic resection of premalignant and malignant endometrial polyps:Is it a safe alternative to hysterectomy?[J].J Minim Invasive Gynecol,2017,24(7):1200-1203.
[10] 陈华丽.彩色多普勒超声联合血清脂联素检测在子宫内膜癌诊断中的价值[J].中国妇幼保健,2017,32(21):5452-5455.
[11] 金影,郝增平.老年女性无症状单纯子宫内膜增厚的临床分析[J].中国医刊,2017,52(11):90-92.
[12] 曾文杰,敬毅,徐海鸥.172例异常子宫出血的宫腔镜诊治分析[J].浙江实用医学,2017,22(5):364-366.
[13] 张保华,冯晓丹,申丽,等.联合宫腔刷及宫腔吸管采集子宫内膜在子宫内膜癌筛查中的应用[J].实用癌症杂志,2017,32(10):1685-1687.
[14] 吴海,杨学荣,鄢利梅,等.左炔诺孕酮宫内缓释系统治疗子宫内膜癌癌前病变患者的临床效果观察[J].中国妇幼保健,2017,32(17):4038-4041.
[15] 李秋霞,余贵媛,金平.年轻子宫内膜癌女性保留生育及卵巢功能的治疗进展[J].国际妇产科学杂志,2018,45(1):75-79.
[16] 余花艳,任统伟.养正消积胶囊辅助宫腔镜治疗早期子宫内膜癌的疗效研究[J].实用癌症杂志,2018,33(2):340-342.
[17] 乔金凤,刘江华,华文文.宫腔镜联合阴道高频彩超对子宫内膜癌的诊断价值[J].实用癌症杂志,2018,33(1):153-155.
[2] Lucic N,Draganovic D,Sibincic S,et al.Myometrium invasion,tumour size and lymphovascular invasion as a prognostic factor in dissemination of pelvic lymphatics at endometrial carcinoma[J].Med Arch,2017,71(5):325-329.
[3] Stachowicz N,Mazurek D,Czekierdowski A.Diagnostic hysteroscopy and the risk of malignant cells intraabdominal spread in women withendometrial cancer[J].Ginekol Pol,2017,88(10):562-567.
[4] 姚广,雷敏,吕晓,等.子宫内膜癌的早期诊断研究进展[J].中国妇幼保健,2018,33(1):235-237.
[5] 朱瑜苑,王刚.左炔诺孕酮宫内缓释系统在子宫内膜癌保留生育功能治疗中的应用[J].中国实用妇科与产科杂志,2017,33(12):1296-1299.
[6] 王妨妨,林俊,于爱军.保留生育功能的宫腔镜手术联合孕激素治疗Ia期子宫内膜癌9例临床分析[J].浙江医学,2017,39(22):2029-2031,2046.
[7] 李品莹,李小毛.子宫内膜癌保留生育功能的研究进展[J].新医学,2017,48(11):753-756.
[8] Zhang R,Gu P,Liu Q,et al.Analysis of diagnosis and treatment of complicated cervical severe adhesion atresia after removal of endometrial stromal nodule:A case report[J].Medicine (Baltimore),2017,96(48):e8979.
[9] Elyashiv O,Sagiv R,Kerner R,et al.Hysterscopic resection of premalignant and malignant endometrial polyps:Is it a safe alternative to hysterectomy?[J].J Minim Invasive Gynecol,2017,24(7):1200-1203.
[10] 陈华丽.彩色多普勒超声联合血清脂联素检测在子宫内膜癌诊断中的价值[J].中国妇幼保健,2017,32(21):5452-5455.
[11] 金影,郝增平.老年女性无症状单纯子宫内膜增厚的临床分析[J].中国医刊,2017,52(11):90-92.
[12] 曾文杰,敬毅,徐海鸥.172例异常子宫出血的宫腔镜诊治分析[J].浙江实用医学,2017,22(5):364-366.
[13] 张保华,冯晓丹,申丽,等.联合宫腔刷及宫腔吸管采集子宫内膜在子宫内膜癌筛查中的应用[J].实用癌症杂志,2017,32(10):1685-1687.
[14] 吴海,杨学荣,鄢利梅,等.左炔诺孕酮宫内缓释系统治疗子宫内膜癌癌前病变患者的临床效果观察[J].中国妇幼保健,2017,32(17):4038-4041.
[15] 李秋霞,余贵媛,金平.年轻子宫内膜癌女性保留生育及卵巢功能的治疗进展[J].国际妇产科学杂志,2018,45(1):75-79.
[16] 余花艳,任统伟.养正消积胶囊辅助宫腔镜治疗早期子宫内膜癌的疗效研究[J].实用癌症杂志,2018,33(2):340-342.
[17] 乔金凤,刘江华,华文文.宫腔镜联合阴道高频彩超对子宫内膜癌的诊断价值[J].实用癌症杂志,2018,33(1):153-155.