摘要
目的探讨绝经过渡期及绝经后期不伴不典型增生子宫内膜增生(EH)患者的临床特征、治疗方式及预后转归。方法回顾分析2010年8月1日至2020年8月1日北京大学人民医院收治的绝经过渡期及绝经后期EH患者的临床资料、治疗转归及结局。结果169例绝经过渡期及绝经后期EH患者的平均年龄(49.98±6.22)岁,平均BMI(25.01±4.05)kg/m^(2),其中绝经过渡期134例(79.3%),绝经后期35例(20.7%)。169例患者临床症状以异常子宫出血最为常见158例(93.5%)。初始治疗全子宫切除术13例(7.7%),初始孕激素治疗156例(92.3%),其中孕激素治疗有效141例(90.4%)、孕激素治疗无效15例(9.6%)。Logistic多因素分析显示,反复异常子宫出血(≥3次)(P<0.01)及子宫内膜复杂性增生(P<0.01)是影响孕激素治疗结局的独立高危因素。结论绝经过渡期及绝经后期EH患者对孕激素治疗有效率高;反复异常子宫出血及子宫内膜复杂性增生者病变持续和进展的比率高、孕激素治疗反应差,应引起临床重视。
Objective:To investigate the clinical characteristics,treatment methods and prognostic outcomes of menopausal transition and postmenopausal patients with endometrial hyperplasia without atypical hyperplasia.Methods:A retrospective analysis of the clinicopathological characteristics of menopausal transition and postmenopausal patients with endometrial hyperplasia without atypical hyperplasia admitted to Peking University People's Hospital during the period from August 1,2010 to August 1,2020.The basic clinical characteristics,treatment methods and prognostic outcomes of these patients were collected retrospectively.Results:A total of 169 patients,with an average age of(49.98±6.22)years and an average BMI of(25.01±4.05)kg/m^(2) were included in this study.134 cases(79.3%)were menopausal transition and 35 cases were(20.7%)postmenopausal.Among 169 patients,abnormal uterine bleeding was the most common symptom in 158 cases(93.5%).13 cases(7.7%)were initially treated with total hysterectomy,and 156 cases(92.3%)were initially treated with progesterone of which 141 cases were effective(90.4%)and 15 cases(9.6%)underwent total hysterectomy for the non-effective of progesterone.Logistic multivariate analysis demonstrated that repeated abnormal uterine bleeding(≥3 times)(P<0.01)and complicated endometrial hyperplasia(P<0.01)were independent high-risk factors affecting the outcome of progesterone therapy.Conclusion:Progesterone therapy has a high overall effective rate in menopausal transition and postmenopausal patients with endometrial hyperplasia without atypical hyperplasia.Patients with recurrent abnormal uterine bleeding and complicated endometrial hyperplasia have a high incidence of the persistence and progression of endometrial hyperplasia and need more attention in the clinical practice.
作者
董媛媛
田昭
张栋栋
欧阳方贵
张琛
翟庆杰
崔恒
祝洪澜
Dong Yuanyuan;Tian Zhao;Zhang Dongdong(Department of Obstetrics and Gynecology,Peking University People's Hospital,Beijing 100044;Department of Obstetrics and Gynecology,Beijing Fangshan District Maternal and Child Health Hospital,Beijng 102488;Department of Obstetrics and Gynecology,Maternal and Child Health Hospital of Zibo City,Zibo 255029)
出处
《现代妇产科进展》
CSCD
北大核心
2022年第4期241-245,共5页
Progress in Obstetrics and Gynecology
基金
北京大学人民医院研究与发展基金(No:RDH2021-06)
北大医学交叉研究种子基金(No:BMU2020MX003)
中央高校基本科研业务费资助。
关键词
子宫内膜增生
不伴不典型增生
复杂性增生
孕激素治疗
绝经过渡期
绝经后期
Endometrial hyperplasia
Endometrial hyperplasia without atypical hyperplasia
Complex endometrial hyperplasia
Progesterone therapy
Menopausal transition
Postmenopau
