ĐẶC ĐIỂM LÂM SÀNG, HÌNH ẢNH SIÊU ÂM VÀ KẾT QUẢ ĐIỀU TRỊ TĂNG SINH NỘI MẠC TỬ CUNG BẰNG PHƯƠNG PHÁP ĐIỀU TRỊ NỘI KHOA TẠI BỆNH VIỆN PHỤ SẢN THÀNH PHỐ CẦN THƠ NĂM 2023-2025

Abstract

Objective: To investigate the clinical characteristics, ultrasound findings, and treatment outcomes of endometrial hyperplasia (EH) using medical therapy at Can Tho City Maternity Hospital. Subjects and methods: A cross-sectional descriptive study was conducted on 55 patients who were examined and treated for endometrial hyperplasia with medical therapy at Can Tho City Maternity Hospital from June 2023 to January 2025. Patients were monitored for clinical outcomes after three months of treatment. Results: The majority of patients were between 40-60 years old, accounting for 72.7%, with a mean age of 49.75 ± 9.39 years. Most patients resided in urban areas (76.4%). The proportion of obese patients was 50.9%, which was nine times higher than that of underweight patients. The most frequent clinical symptoms were abnormal uterine bleeding (76.4%) and lower abdominal pain (80%). Endometrial thickening on ultrasound was found in 81.8% of cases, with an average endometrial thickness of 14.15 ± 7.26 mm. The incidence of typical endometrial hyperplasia accounts for 96.4%, while atypical endometrial hyperplasia accounts for 3.6%. After one and three months of treatment, endometrial thickness significantly changed, with a statistically significant difference (p < 0.001). The number of menstruation days in premenopausal patients also showed a statistically significant change (p < 0.05). Postmenopausal bleeding was significantly reduced after three months, with only 18.2% of patients experiencing bleeding for less than seven days and 0% experiencing bleeding for more than seven days. Conclusion: Endometrial hyperplasia most commonly presents with abnormal uterine bleeding, including menorrhagia and metrorrhagia. Ultrasound imaging plays a crucial role in diagnosis, aiding in the assessment of endometrial thickness and classification of lesions. Regarding medical treatment, this approach is simple, effective, and cost-efficient. Studies have reported a positive response rate to progestin therapy and other hormonal treatment regimens. These therapies help control symptoms, reduce endometrial thickness, and minimize the risk of progression to endometrial cancer. Additionally, they improve disease prognosis, enhance patients’ quality of life, and preserve reproductive organs.