摘要
目的探讨不孕症合并子宫内膜非典型增生患者的临床特点及其治疗方案。方法回顾性分析18例不孕症合并子宫内膜非典型增生患者(非典型增生组)的病理结果、临床特点、B超检查结果、FBG、性激素、血清糖类抗原(CA)125水平及治疗、妊娠结局。设同期就诊的输卵管梗阻不孕症患者23例为对照组。结果 18例子宫内膜非典型增生患者的病理检查结果为轻度不典型增生5例,中度不典型增生10例(合并复杂型子宫内膜增生过长2例,子宫内膜息肉3例),重度非典型增生3例。非典型增生组年龄、体质指数、收缩压值、月经紊乱发生率、阴道不规则流血发生率、子宫内膜异常发生率、空腹血糖水平、雌二醇水平均大于/高于对照组(P<0.05)。重度非典型增生或复杂型非典型增生5例患者行根治性子宫切除术,其余13例给予大剂量孕激素治疗病情缓解后行助孕治疗,获得妊娠4例(30.77%)。结论不孕症并子宫内膜非典型增生患者多表现为月经混乱、子宫内膜结构异常及部分内分泌指标异常。轻中度子宫内膜非典型增生患者可采用大剂量孕激素治疗加助孕治疗,而重度患者宜手术治疗。
Objective To study the clinical characteristics and treatment of endometrial atypical hyperplasia in infertility patients. Methods Clinical data of 18 infertility patients with endometrial atypical hyperplasia （atypical hyperplasia group） were retrospectively analyzed, including pathological results, clinical characteristics, B ultrasound examination results, FBG, hormone, serum carbohydrate antigen （CA） 125 level, treatment and pregnancy outcome. Twenty-three patients with infertility due to fallopian tube obstruction were enrolled in the control group. Results Pathological results of 18 patients with endometrial atypical hyperplasia revealed that 5 cases of mild atypical hyperplasia,10 cases of moderate, including 2 cases of complex endometrial hyperplasia and 3 cases of endometrial polyps, and 3 cases of severe. Age, body mass index, SBP, incidence rates of menstrual disorder, abnormal vaginal bleeding and endometrial abnormality, and levels of FBG and estradiol in patients with endometrial atypical hyperplasia were greater/higher than those in the control group（P 〈 0.05 ）. Five patients with severe or complexity atypical hyperplasia received radical hysterectomy, and the other 13 cases were treated with assisted reproduction technology after remission due to a large-dose progesterone therapy,and 4 cases （30.77%） were pregnant. Conclusion Infertility complicated with endometrial atypical hyperplasia is commonly manifested by menstrual disorder, endometrial structure abnormality and abnormality in some endocrine indexes. Patients with mild/moderate endometrial atypical hyperplasia might be treated with a large-dose progesterone therapy plus assisted reproductive technology,while the severe patients might be treated with surgical treatment.
出处
《广西医学》
CAS
2017年第4期433-435,共3页
Guangxi Medical Journal
基金
国家自然科学基金(81260096)
广西优秀博士论文培育计划(YCBZ2014033)
广西自然科学基金(2014GXNSF118199)
关键词
不孕症
子宫内膜非典型增生
临床诊治
Infertility, Endometrial atypical hyperplasia, Clinical diagnosis and treatment
