【摘要】 [目的 ]对绝经后经三苯氧胺 (TAM )治疗的乳腺癌术后的患者进行随访 ,观察在随访期内子宫的病变 ,并采取相应的对策。 [方法 ]随机选择 6 5例绝经后患者口服TAM 2 0mg/d ,每隔 6～ 12个月作经阴道B超检查 ,对于子宫内膜厚度≥ 5mm的患者行诊断性刮宫。[结果 ]可评价患者共5 6例 ,服用TAM的平均时间为 39个月。服用TAM后 ,子宫内膜明显增厚 ,经诊刮后其中 13例为单纯性增生 ,3例为子宫内膜息肉。其中 3例内膜增厚伴阴道出血的患者停药后 6个月后子宫内膜厚度恢复正常。服药期间有 5例患者发现子宫肌瘤增大 ,无子宫内膜癌的发生。 [结论 ]乳腺癌术后长期口服TAM ,可引起绝经后患者子宫内膜单纯性增生、子宫内膜息肉及子宫肌瘤。因此 ,应该对长期服用TAM的患者进行密切随访 ,可防止子宫内膜癌的发生。更多还原

【Abstract】 [Objective] A following-up was given to the postmenopausal patients with breast cancer taking TAM after operation, the pathologic change of uterus was observed during the following-up period and suitable treatment was taken. [Methods] A random sample of 65 patients was given TAM 20 mg per day, evaluated with transvaginal sonographic every 6～12 months. For patients with endometrial thickness more than 5mm, the diagnostic curettage and endometrial biopsy should be given.[Results] Fifty-six patients were evaluated. The medial time of taking TAM was 39 months. After TAM treatment, endometrium was thicker obviously, uterine pathological examination indicated 13 patients with simple hyperplasia, 3 patients with endometrial polyp and 5 cases with hysteromyoma. The 3 patients with endometrial thickness more than 5 mm and colporrhagia could recover in 6 months after stopping therapy. [Conclusion] Long-term therapy to the postmenopausal patients may result in endometrial hyperplasia, polyp and hysteromyoma. Therefore, patients with long-term TAM treatment must be closely followed so as to preventing the occurrence of the endometrial carcinoma.更多还原