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年轻内膜癌患者中尚未生育的比例高达70%,孕激素及含孕激素宫内节育器(IUD)治疗后的缓解率均较满意(76%~88%),但复发率也较高,为20%~38%。不同孕激素制剂治疗缓解后的妊娠率为33%~83%,特别是在使用了辅助生殖技术(ART)之后,妊娠率高于等待自然妊娠。在使用ART技术的内膜癌患者中,复发率并未增加。为减少刮宫对内膜的损伤,可6个月诊断性刮宫1次,如果2次内膜正常,则可试孕。复发的中位时间跨度较大,为4~102个月,多报道为24个月。为争取在复发前尽早妊娠,主张积极助孕。完成生育后是否切除子宫,仍有争议。胰岛素抵抗(IR)被认为与内膜癌的发生、发展密切相关,应同时注重IR的评估和改善,这对防止内膜癌复发很有帮助。
In young patients with endometrial cancer has not yet been fertilized as high as 70%, progesterone and progesterone-containing IUD treatment were more satisfactory response rate (76% to 88%), but the recurrence rate is also high, 20% to 38%. Pregnancy rates varied from 33% to 83% after treatment with different progestin agents, especially after using ART, pregnancy rates were higher than waiting for natural pregnancies. In ART patients with endometrial cancer, the recurrence rate did not increase. To reduce the curettage of endometrial damage, 6 months of diagnostic curettage 1 times, if the 2 endometrial normal, you can try pregnancy test. The median time to recurrence was large, ranging from 4 to 102 months, with multiple reports of 24 months. In order to strive for early pregnancy before relapse, advocate active pregnancy. Whether to remove the uterus after completion of fertility is still controversial. Insulin resistance (IR) is thought to be closely related to the occurrence and development of endometrial cancer. At the same time, the evaluation and improvement of IR should be emphasized. This is helpful to prevent the recurrence of endometrial cancer.