甲羟孕酮与地屈孕酮分别联合宫腔镜电切术治疗早期雌激素依赖型子宫内膜癌的临床观察
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篇名: 甲羟孕酮与地屈孕酮分别联合宫腔镜电切术治疗早期雌激素依赖型子宫内膜癌的临床观察
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摘要: 目的:比较甲羟孕酮与地屈孕酮分别联合宫腔镜电切术治疗早期雌激素依赖型子宫内膜癌的疗效和安全性。方法:42例早期雌激素依赖型子宫内膜癌患者随机分为甲羟孕酮组(21例)和地屈孕酮组(21例)。两组患者均行宫腔镜电切术。甲羟孕酮组患者于手术当日起口服醋酸甲羟孕酮片100 mg,每日3次;地屈孕酮组患者于手术当日起口服地屈孕酮片10 mg,每日2次。两组疗程均为6个月。观察两组患者的临床疗效,治疗前及治疗3、12个月后的血清糖类抗原125(CA125)水平和治疗前后的体质量及不良反应发生情况。结果:治疗3个月后,地屈孕酮组患者总有效率显著低于甲羟孕酮组,差异有统计学意义(P<0.05);治疗12个月后,两组患者总有效率均显著高于同组治疗3个月后,差异均有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。治疗前,两组患者血清CA125水平、体质量比较,差异均无统计学意义(P>0.05)。治疗3、12个月后,两组患者血清CA125水平均显著低于同组治疗前,治疗12个月后均低于治疗3个月后,且治疗3个月后地屈孕酮组高于甲羟孕酮组,差异均有统计学意义(P<0.05),但两组治疗12个月后比较差异无统计学意义(P>0.05)。治疗后,甲羟孕酮组患者体质量显著高于同组治疗前,差异有统计学意义(P<0.05);地屈孕酮组患者与治疗前比较差异无统计学意义(P>0.05)。地屈孕酮组患者不良反应发生率显著低于甲羟孕酮组,差异有统计学意义(P<0.05)。结论:甲羟孕酮联合宫腔镜电切术治疗早期雌激素依赖型子宫内膜癌的近期疗效虽然优于地屈孕酮联合宫腔镜电切术,但前者不良反应发生率较高,两者远期疗效相当。
ABSTRACT: OBJECTIVE: To compare the efficacy and safety of medroxyprogesterone or dydrogesterone combined with hysteroscopic electrosurgery in the treatment of early estrogen-dependent endometrial cancer. METHODS: 42 patients with early estrogen-dependent endometrial cancer were randomly divided into medroxyprogesterone group (21 cases) and dydrogesterone group (21 cases). All patients received hysteroscopic electrosurgery. Medroxyprogesterone group received 100 mg Medroxyprogesterone acetate tablet, 3 times a day. Dydrogesterone group received 100 mg Dydrogesterone tablet, twice a day. The treatment course for both groups was 6 months. Clinical efficacy, carbohydrate antigen CA125 (CA125), body mass and the incidence of adverse reactions in 2 groups were observed. RESULTS: After 3 months of treatment, the total effective rate in dydrogesterone group was significantly lower than medroxyprogesterone group, the difference was statistically significant (P<0.05). After 12 months, the total effective rates in 2 groups were significantly higher than 3 months, the difference was statistically significant (P<0.05), but there was no significant difference between 2 groups (P>0.05). Before treatment, there were no significant differences in CA125 and body mass in 2 groups (P>0.05). After 3 and 12 months, CA125 levels in 2 groups were significantly lower than before, 12 months was lower than 3 months, and dydrogesterone group was higher than medroxyprogesterone group after 3 months, the differences were statistically significant (P<0.05), but there were no significant differences between 2 groups after 12 months (P>0.05). After treatment, the body mass in medroxyprogesterone group was significantly higher than before, the difference was statistically significant (P<0.05); while there was no significant difference in dydrogesterone group before and after treatment (P>0.05). And the incidence of adverse reactions in dydrogesterone group was significantly lower than medroxyprogesterone group, the difference was statistically significant (P<0.05). CONCLUSIONS: The short-term efficacy of medroxyprogesterone combined with hysteroscopic electrosurgery is superior to dydrogesterone combined with hysteroscopic electrosurgery in the treatment of early estrogen-dependent endometrial cancer, but medroxyprogesterone combined with hysteroscopic electrosurgery shows high incidence of adverse reactions. Long-term effects of both Dydrogesterone and Medroxyprogesterone are equivalent.
期刊: 2016年第27卷第21期
作者: 张正娥
AUTHORS: ZHANG Zheng’e
关键字: 地屈孕酮;甲羟孕酮;宫腔镜电切术;早期雌激素依赖型子宫内膜癌;疗效;安全性
KEYWORDS: Dydrogesterone; Medroxyprogesterone; Hysteroscopic electrosurgery; Early estrogen-dependent endometrial cancer; Efficacy; Safety
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