去氧孕烯炔雌醇联合米非司酮治疗围绝经期无排卵型功能失调性子宫出血的临床观察  

Clinical Observation of Desogestrel Combined with Mifepristone in the Treatment of Perimenopausal Dysfunctional Uterine Bleeding with No Ovulation

作　　者：李雪萍[1] 罗菊玉 

机构地区：[1]黔东南民族职业技术学院妇产科教研室,贵州凯里556000 [2]黔东南州人民医院妇科,贵州凯里556000

出　　处：《中国药房》2016年第14期1981-1983,共3页China Pharmacy

摘　　要：目的:探讨去氧孕烯炔雌醇联合米非司酮对围绝经期无排卵型功能失调性子宫出血(DUB)患者激素水平和子宫内膜厚度的影响,并观察其止血效果及安全性。方法:采用回顾性研究方法,将92例围绝经期无排卵型DUB患者按不同治疗方案分为观察组(48例)与对照组(44例)。对照组患者在止血、抗感染等对症治疗基础上,于刮宫术后病理报告确诊当天给予米非司酮片口服,每天1片,30 d为1个疗程,共治疗3个疗程;观察组患者在对照组治疗基础上加服去氧孕烯炔雌醇片,每天1片,21 d为1个疗程,出现撤药性出血以后第4天开始第2个疗程,共治疗3个疗程。比较两组患者治疗前后的激素水平、子宫内膜厚度、止血情况与不良反应发生情况。结果:与治疗前比较,两组患者治疗后血清中的孕酮、雌激素水平明显下降,差异均具有统计学意义(P<0.05);观察组患者治疗后血清中的促卵泡生成素(FSH)、黄体生成素(LH)水平和子宫内膜厚度明显低于治疗前及对照组,差异均具有统计学意义(P<0.05)。观察组患者的控制出血时间和完全止血时间明显短于对照组,差异均具有统计学意义(P<0.05)。观察组患者的不良反应发生率为8.33%,对照组为13.64%,组间比较差异无统计学意义(P>0.05)。结论:去氧孕烯炔雌醇联合米非司酮对围绝经期无排卵型DUB的疗效较好,可有效降低患者FSH和LH水平,缩短止血时间,且不良反应较少。OBJECTIVE：To observe the effects of desogestrel combined with mifepristone on hormene level and endometrial thickness in patients with perimenopausal dysfunctional uterine bleeding（DUB）with no ovulation and to osberve hemostatic effect.METHODS：In retrospective study,92 patients with the perimenopausal DUB were divided into observation group（48 cases）and control group（44 cases）. Control group received symptomatic treatment such as hemostasis,anti-infective treatment,and Mifepristone tablet orally,1 tablet erevy day,on pathological report diagnosis. A treatment course lasted for 30 d,and there were 3 courses of treatment in total. Observation group was additionally given Desogestrel tablet,1 tablet erevy day,21 d as a treatment course,received second course on the forth day of drug withdrawal hemorrhage,3 courses in total. Hormone level and endometrial thickness before and after treatment,and hemostasis and the occurrence of ADR were compared between 2 groups. RESULTS：Compared with before treatment,serum level of progesterone and estrogen decreased in 2 groups significantly after treatment,with statistical significance（P〈0.05）;after treatment,serum level of FSH and LH,endometrial thickness in observation group were significantly lower than before treatment and control group,with statistical significance（P〈0.05）. Controlling bleeding time and complete hemostasis time of observation group were significantly shorter than those of control group,with statistical significance（P〈0.05）. The incidence of ADR in observation group was 8.33%,and that of control group was 13.64%,without statistical significance（P〉0.05）. CONCLUSIONS：Desogestrel combined with mifepristone is effective for perimenopausal DUB with no ovulation,can effectively reduce FSH and LH levels,and shorten hemostatic time with less ADR.

关 键 词：去氧孕烯炔雌醇 米非司酮 无排卵型功能失调性子宫出血 围绝经期 

分 类 号：R711.52[医药卫生—妇产科学]