左炔诺孕酮宫内缓释系统对于乳腺癌术后子宫内膜药物性改变的保护作用  

Protective effect of levonorgestrel intrauterine sustained-release system on pharmacologic changes of endometrium after breast cancer surgery

作　　者：肖雪莲[1] 梁文通[1] 倪青[2] 魏娜[2] 陈华建[2] 高宇哲[2] 张志军[1] 江恩利[1] 王玉娟[1] XIAO Xuelian;LIANG Wentong;NI Qing;WEI Na;CHEN Huajian;GAO Yuzhe;ZHANG Zhijun;JIANG Enli;WANG Yujuan(Guizhou Provincial People's Hospital,Guizhou, Guiyang 550002,China)

机构地区：[1]贵州省人民医院妇科,550002 [2]贵州省人民医院乳腺外科

出　　处：《中国妇产科临床杂志》2019年第2期139-142,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：贵州省科技厅-贵州省人民医院联合基金项目:【黔科合LH字(2015)7118号】;贵阳市科技计划项目:【筑科合同(20151001)社67号】

摘　　要：目的探讨左炔诺孕酮宫内缓释系统对于乳腺癌术后服用他莫昔芬引起的子宫内膜药物性改变的效果。方法选取2015年10月至2017年2月在贵州省人民医院行乳腺癌手术患者59例,根据随机数字表法将患者分为两组,对照组29例给予他莫昔芬(TAM)治疗,观察组30例在对照组的基础上放置左炔诺孕酮宫内缓释系统。比较两组患者不同时间月经情况、超声下子宫内膜厚度、宫腔镜下病理学检查结果。结果观察组患者治疗6个月时闭经情况显著低于对照组,不规则阴道出血情况显著高于对照组(P <0.05),两组患者治疗12个月时月经情况无统计学差异(P> 0.05);两组治疗前、治疗3个月和治疗6个月时患者的子宫内膜厚度相比无统计学差异(P>0.05),治疗12个月时观察组患者的子宫内膜厚度显著低于对照组(P <0.05);宫腔镜下子宫内膜病理结果提示观察组子宫内膜情况优于对照组(P <0.05)。结论采用左炔诺孕酮宫内缓释系统可有效降低乳腺癌术后他莫昔芬引起的子宫内膜改变。Objective To investigate the effect of levonorgestrel intrauterine sustained-release system on endometrial changes induced by tamoxifen after breast cancer surgery Methods 59 patients who underwent breast cancer surgery in Guizhou provincial hospital from October 2015 to February 2017 were selected.Patients were divided into two groups according to the random number table method.29 patients in the control group were treated with tamoxifen(TAM),and 30 patients in the observation group were treated with levonorgestrel intrauterine sustained-release system on the basis of the control group.Endometrial thickness and menstruation at different time,B ultrasound,hysteroscopy and pathological examination results were compared between the two groups.Results The amenorrhea of the observation group was signif icantly lower than that of the control group at 6 months after treatment,and the irregular vaginal bleeding was significantly higher than that of the control group(P <0.05).There was no statistical difference in menstrual status between the two groups at 12 months after treatment(P >0.05).There was no statistically signif icant difference in endometrial thickness between the two groups before treatment,3 months after treatment and 6 months after treatment(P >0.05).The endometrial thickness of the observation group at 12 months after treatment was signif icantly lower than that of the control group(P <0.05).The situation of endometrium in the observation group with hysteroscopy examination was better than that in the control group(P <0.05).Conclusion Levonorgestrel intrauterine sustained-release system can effectively reduce the changes of endometrium caused by tamoxifen after breast cancer surgery.

关 键 词：乳腺癌 他莫昔芬 子宫内膜 左炔诺孕酮 

分 类 号：R737.9[医药卫生—肿瘤]