预防性使用曼月乐环对他莫昔芬治疗的乳腺癌患者子宫内膜病变的疗效  

Efficacy of prophylactic use of Mirena for endometrial lesions in breast cancer patients treated with tamoxifen

作　　者：唐润薇 张英辉[2] TANG Run-wei;ZHANG Ying-hui(Department of Breast Surgery,Baoshan District Hospital of Integrated Traditional and Western Medicine,Shanghai 201900,China;Department of breast Shanghai Jiading District Maternal and Child Health Hospital,Shanghai 201821,China)

机构地区：[1]上海市宝山区中西医结合医院乳腺外科,上海201900 [2]上海市嘉定区妇幼保健院乳腺科,上海201821

出　　处：《医药论坛杂志》2023年第4期17-20,25,共5页Journal of Medical Forum

基　　金：上海市嘉定区卫生和计划生育委员会科研课题(2016-KY-13)。

摘　　要：目的 评估预防性使用曼月乐环对他莫昔芬治疗的乳腺癌患者子宫内膜病变的疗效。方法 选取2017年7月至2019年4月上海市宝山区中西医结合医院就诊的他莫昔芬治疗的乳腺癌患者,随机分为治疗组和对照组。对照组进行常规治疗,治疗组预防性置入曼月乐环。治疗随访24个月,通过宫腔镜和子宫内膜取样检查,比较两组患者子宫内膜病变情况。结果 最终对照组48例,治疗组46例完成实验。治疗组子宫内膜息肉发生率低于对照组,差异有统计学意义(P<0.05)。基线和随访2年期间两组子宫内膜厚度差异无统计学意义(P>0.05)。治疗组随访期内增生期子宫内膜例数低于对照组,子宫内膜息肉发生率低于对照组,差异有统计学意义(P<0.05),黏膜下纤维瘤的发生率两组差异无统计学意义(P>0.05)。结论 使用曼月乐环对接受他莫昔芬治疗的乳腺癌患者新发子宫内膜息肉有一定的预防作用。Objective To evaluate the effect of prophylactic use of Mirena on endometrial lesions in breast cancer patients treated with tamoxifen.Methods Patients with breast cancer treated with tamoxifen from July 2017 to April 2019 were selected and randomly divided into a treatment group and a control group.The control group received routine treatment, while the treatment group received Mirena ring preventively.The patients were followed up for 24 months, and the endometrial lesions of the two groups were compared by hysteroscopy and endometrial sampling.Results In the end, 48 cases in the control group and 46 cases in the treatment group completed the experiment.The incidence of endometrial polyps in the treatment group was lower than that in the control group, and the differences were statistically significant(P<0.05).There was no significant difference in endometrial thickness between the two groups at baseline and during the 2-year follow-up period(P>0.05).During the follow-up period, the number of cases of endometrial hyperplasia in the treatment group was lower than that of the control group, the incidence of endometrial polyps was lower than that of the control group, and the difference was statistically significant(P<0.05).There was no difference in the incidence of submucosal fibroids between the two groups.Statistical significance(P>0.05).Conclusion The use of Mirena has a certain preventive effect on new endometrial polyps in breast cancer patients treated with tamoxifen.

关 键 词：曼月乐环 他莫昔芬 乳腺癌 子宫内膜病变 

分 类 号：R137.9[医药卫生—劳动卫生]