有生育要求女性子宫内膜不典型增生的微创治疗

目的：探讨对于有生育要求的子宫内膜不典型增生患者采用宫腔镜微创治疗保留子宫的疗效。方法：回顾性分析新疆医科大学第一附属医院2000年1月-2013年3月因子宫内膜不典型增生行子宫内膜电切术（TCRE）的30例患者的临床资料。术后口服高效孕激素（甲羟孕酮）160mgqd3月或置入宫内左炔诺孕酮宫内缓释植入系统（曼月乐），对两组患者月经及子宫内膜的病理进行随访。结果：两组患者TCRE手术均顺利完成，未发生严重并发症，术后月经过多、经期延长及贫血均得到明显改善，总有效率93．73％。其中口服高效孕激素组有效率为90．48％，置入曼月乐组有效率为96．30％。结论：对有随访条件的年轻的子宫内膜不典型增生患者，TCRE术联合孕激素或置入曼月乐是治疗的新选择，针对妇女的生育要求可以选择不同的术后用药。微创治疗提高了妇女的生存质量，并发症少。

Observation on Curative Effect of TCRE and Progestogen Combingtreatment in Atypical Hyperplasia of Endometrium

Objective： To investigate the curative effect of atypical hyperplasia of endometriurn by transcervical resection of en- dometrium （TCRE） and progestogen. Methods： Clinical data of 30 patients with atypical hyperplasia of endometrium were analyzed ret- rospectively in our hospital from 2000 to 2013 March, which were treated by TCRE＋postoperative progestogen （medroxyprogesterone） 160 mg qd for 3 months or insertion of intrauterine levonorgestrel intrauterine implantation system （Mirena）, menstruation and endometrial pathology were followed up. Results： 30 cases were completely resected by hysteroscopy without serious complication, hypermenorrhea menostaxis and anemia of 30 patients after operation were improved, total effective rate was 93.73% Conclusion： The treatment of atypical hyperplasia of endometrium by TCRE combing progestogen or insertion of intrauterine levonorgestrel intrauterine implantation system （Mirena） have satisfying effect for the patients. The technique improves woman＇s survival quality and the complication few.