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目的对孕激素治疗高分化子宫内膜样癌及子宫内膜重度不典型增生患者的临床效果进行分析讨论。方法2005年5月-2015年5月期间,该院接收高分化子宫内膜样癌患者13例,定义为癌变组,子宫内膜重度不典型增生的患者28例,定义为增生组,2组患者均要求以保留子宫为前提接受治疗,故临床予以孕激素保守治疗。对癌变组、增生组患者接受治疗后的显效人数、无效人数、1年内复发人数进行回顾性分析讨论,同时,对患者进行为期2年的随访调查,统计2组患者2年内自然受孕率、人工受孕率、分娩率、未孕率等,并对上述结果进行分析讨论。结果 2组患者均接受为期半年的孕激素治疗,取得较明显的临床效果,提示试验圆满成功。癌变组12例患者在接受治疗后症状得到有效控制,1例患者接受孕激素治疗后效果不明显,临床有效率为92.31%,无效率为7.69%。出院1年内2例患者病情复发,复发率为15.38%;增生组28例患者在接受治疗后症状均得到有效控制,临床有效率为100.00%,无效率为0,出院1年内3例患者病情复发,复发率为10.71%。2年内癌变组患者6例自然受孕成功,百分比为46.15%;3例患者人工受孕成功,百分比为23.08%;8例患者成功分娩,百分比为61.53%;4例患者未能成功受孕,占全组百分比为30.77%。2年内非癌变组患者17例自然受孕成功,百分比为60.71%;6例患者人工受孕成功,百分比为21.43%;上述23例患者均成功分娩,百分比为82.14%;5例患者未能成功受孕,占全组百分比为17.86%。结论对于高分化子宫内膜样癌及子宫内膜重度不典型增生患者应用孕激素保守治疗,临床疗效显著,同时多数患者受孕、分娩成功,可作为首选治疗手段在临床上推广。
Objective To analyze the clinical effects of progestin on patients with highly differentiated endometrioid carcinoma and endometrial dysplasia. Methods From May 2005 to May 2015, 13 patients with well-differentiated endometrioid carcinoma were enrolled in this hospital, which were defined as canceration group and 28 patients with severe endometrial dysplasia, which were defined as hyperplasia group, 2 groups Patients are required to retain the premise of treatment of the uterus, it is clinically progesterone conservative treatment. The number of patients with canceration and hyperplasia was evaluated retrospectively after treatment. The patients were followed up for 2 years. The rate of spontaneous conception in two groups within 2 years was calculated, Pregnancy rate, delivery rate, non-pregnancy rate, etc., and the above results were analyzed and discussed. Results The two groups of patients received six months of progestin therapy, achieved more obvious clinical results, suggesting that the trial was a success. Twelve patients in the cancerous group were effectively controlled after receiving treatment. One patient had no obvious effect after receiving progestin. The clinical effective rate was 92.31% and the inefficiency rate was 7.69%. The relapse rate was 15.38% in 2 patients within 1 year after discharge. The symptom of 28 patients in proliferative group was effectively controlled after treatment. The clinical effective rate was 100.00%, the inefficiency rate was 0, and the recurrence rate was found in 3 patients within 1 year after discharge , The recurrence rate was 10.71%. In 6 years, 6 cases of cancerous patients successfully conceived spontaneously, the percentage was 46.15%; 3 cases of artificial conception succeeded, the percentage was 23.08%; 8 cases of successful delivery, the percentage was 61.53%; 4 patients failed to conceive, accounting for the whole group The percentage is 30.77%. 17 cases of non-cancerous patients within 2 years of successful natural conception, the success rate of 60.71%; 6 cases of artificial pregnancy success, the percentage was 21.43%; The above 23 patients were successfully delivered, the percentage was 82.14%; 5 patients failed to conceive successfully, The percentage of the whole group was 17.86%. Conclusions For patients with highly differentiated endometrioid carcinoma and severe dysplasia of endometrium, conservative treatment with progestin is required. The clinical effect is significant. At the same time, most patients have successful pregnancy and childbirth, and can be used as the first choice of treatment in clinic.