3种方法治疗围绝经期DUB的疗效与安全性评价  

Curative effects of three methods on perimenopausal DUB and safety evaluation

作　　者：陈甦[1] 金松[1] 郑小妹[1] 

机构地区：[1]海南医学院附属医院妇产科,海口570102

出　　处：《西南国防医药》2015年第12期1319-1322,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的 比较米非司酮和左炔诺孕酮宫内缓释系统（LNG-IUS）治疗围绝经期功能失调性子宫出血（DUB）的疗效和安全性。方法 将141例围绝经期DUB患者随机分入LNG-IUS组（宫内放置LNG-IUS）、米非司酮间断组（米非司酮10 mg/晚,连续给药5 d,后5个月月经来潮第1~5 d继续服用米非司酮）、米非司酮连续组（米非司酮10 mg/晚,连续服用6个月）,每组47例,比较3组治疗后的月经量、子宫内膜厚度、血红蛋白浓度、疗效和不良反应。结果 LNG-IUS组有效率为95.74%,米非司酮间断组有效率为68.09%,米非司酮连续组有效率为72.34%,LNG-IUS组有效率显著高于其他两组（P〈0.05）;LNG-IUS组不良反应率为8.51%,明显低于米非司酮间断组（23.40%）和连续组（29.79%）（P〈0.05）。与其他两组相比,治疗3、6个月时,LNG-IUS组的月经量和子宫内膜厚度均显著减少（P〈0.05）,而血红蛋白浓度则显著升高（P〈0.05）。结论 与米非司酮相比,LNG-IUS治疗围绝经期DUB疗效更好,安全性更高。Objective To make comparison between the curative effects and safety of mifepristone and levonorgestrel-releasing intrauterine system （LNG-IUS） on perimenopausal women with dysfunctional uterine bleeding （DUB）. Methods 141 perimenopausal women with DUB were randomly divided into LNG-IUS group （group A）, intermittent mifepristone administration group （group B, mifepristone 10 mg/night for successive 5 days, and continuous use of mifepristone on day 1-5 of the menstruation in the next 5 months）, and continuous mifepristone administration group （group C, mifepristone 10 mg/night for 6 months） with 47 patients in each group. Comparison was made in the volume of menstruation, thicknesses of endometrium, hemoglobin concentration, curative effects, and adverse reactions rates among the three groups after the treatment, Results The effective rates in group A, B, and C were 95.74%, 68.09%, and 72.34%, respectively. The effective rate of group A was significantly higher than that of group B and C （P 〈 0.05）. The adverse reaction rate in group A was 8.51%, which was significantly lower than that in group B （23.40%） and group C （29.79%） （P 〈 0.05）. Compared with the data of the other two groups, the menstruation volume and thicknesses of endometrium in group A significantly decreased, while the hemoglobin concentration significantly increased （P 〈 0.05）. Conclusion Compared with mifepristone, LNG-IUS has better curative effects on perimenopausal DUB with higher safety.

关 键 词：米非司酮 左炔诺孕酮 宫内缓释 围绝经期 功能失调性子宫出血 

分 类 号：R711.52[医药卫生—妇产科学]