屈螺酮炔雌醇联合二甲双胍治疗PCOS合并胰岛素抵抗的子宫内膜癌前期及癌早期患者的临床研究

发布时间：2018-11-15 19:33

【摘要】：目的:探讨PCOS合并胰岛素抵抗的子宫内膜癌早期及癌前患者采用屈螺酮炔雌醇联合二甲双胍药物转化治疗的疗效。方法:回顾分析2010年至2015年济宁市第一人民医院、汶上县人民医院收治的接受屈螺酮炔雌醇联合二甲双胍治疗的30例胰岛素抵抗型PCOS的子宫内膜癌前及癌早期病变患者的临床资料。其中采用高效孕激素治疗失败者16例,首次确诊者14例。30例患者中,诊刮病理为子宫内膜癌前病变者20例,子宫内膜样腺癌高分化G1级者10例。治疗前对患者进行全面分期评估,治疗后每3个月诊刮以评价疗效,对有生育要求者随访其生育情况。结果:30例(100%)患者治疗3~6个月后均获得完全缓解。2例(6.7%)复发。有生育要求的13例患者中,6例(46.2%)成功妊娠。结论:对PCOS合并胰岛素抵抗要求保留子宫的子宫内膜样腺癌早期及子宫内膜不典型增生的患者,采用屈螺酮炔雌醇联合二甲双胍的治疗效果高于单一孕激素。
[Abstract]:Objective: to evaluate the efficacy of oral administration of doxoronisterol combined with metformin in early and precancerous endometrial carcinoma patients with insulin resistance (PCOS). Methods: the first people's Hospital of Jining from 2010 to 2015 was retrospectively analyzed. Clinical data of 30 cases of endometrial precancerous and early cancerous lesions of insulin resistant PCOS treated with truspirone estradiol and metformin in Wenshang County people's Hospital. Of the 30 patients, 20 were diagnosed as endometrial precancerous lesions and 10 as endometrial adenocarcinoma with highly differentiated G1 grade. The patients were evaluated by stages before treatment and curettage every 3 months after treatment. Results: 30 cases (100%) got complete remission after 3 ~ 6 months treatment, and 2 cases (6.7%) recurred. Of the 13 patients with fertility requirement, 6 (46.2%) had successful pregnancy. Conclusion: for patients with PCOS complicated with insulin resistance and endometrioid adenocarcinoma and atypical hyperplasia of endometrium, the therapeutic effect of dipirone estradiol combined with metformin is higher than that of single progesterone.
【作者单位】：汶上县人民医院;济宁市第一人民医院;
【分类号】：R737.33;R711.75

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