Influence of excess body weight on tactics of maintaining women of reproductive age with hyperplastic processes an endometrium

Abstract

The objective: decline of frequency of relapses of hyperplastic processes of endometrium for the women of reproductive age with surplus mass of body on the basis of improvement and introduction of algorithm of treatment-and-prophylactis and prognostic measures. Materials and methods. The conducted researches carried stage-by-stage character. So, on I stage the analysis of clinical – anamnestic, hormonal and metabolic features of patients of reproductive age with surplus mass of body and hyperplastic processes of endometrium is a 1 group (n=90), patients with surplus mass of body, but without the hyperplastic processes of endometrium – 2 group (n=60). On II stage progressive, randomized, opened, comparative research of efficiency of hormonotherapy of hyperplastic processes of endometrium was conducted in 90 women of reproductive age with surplus mass of body (1 group) by the agonist of gonadotropin-releasing hormone (sub-group of 1.1, n=30), progestine (sub-group of 1.2, n=30), by estrogen-gestagenic preparation (sub-group of 1.3, n=30) and means that it is powerful enough. On III stage were found out the factors of risk of uneffectiveness of treatment and recurrent flow of hyperplastic processes of endometrium for the women of reproductive age with obesity. Method of incremental discriminant analysis (n=90): patients with recurrent motion of hyperplastic processes of endometrium (3 group of, n=40), patients without the relapse of hyperplastic processes of endometrium (4 group of, n=50). Results. At the comparative estimation of efficiency of treatment of hyperplastic processes of endometrium for women it was set with surplus mass of body, that frequency of relapses in 24 months takes place for 6,7% patients after therapy of а-GRG, at 46,7% patients which got norethisterone, and for 63,3% women, treated the combined oral contraceptives. A level of the forced operative treatment (hysterectomia) is 3,3% for women which got а-GRG and 23,3% – norethisterone and combined oral contraceptives. Conclusion. For the women of reproductive age with the hyperplastic processes of endometrium and surplus mass of body for treatment most effective and safe in relation to operating there is application of а-GRG on metabolic processes and hormonal status. The use of norethisterone and combined oral contraceptives is possibly in default of found out the factors of risk.