宫腔镜联合地屈孕酮与曼月乐在治疗围绝经期异常子宫出血中的临床应用效果比较  

Clinical application effect comparison of hysteroscopy combined with Dydrogesterone or Mirena in the treatment of perimenopausal abnormal uterine bleeding

作　　者：宋云静[1] 黄俊[1] SONG Yun-jing;HUANG Jun(Department of Gynecology,Ganzhou People′s Hospital,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]江西省赣州市人民医院妇科,江西赣州341000

出　　处：《中国当代医药》2020年第15期126-129,共4页China Modern Medicine

基　　金：江西省赣州市科技计划项目。

摘　　要：目的探讨宫腔镜联合地屈孕酮与曼月乐在治疗围绝经期异常子宫出血中的临床应用效果。方法选取2016年1月~2018年6月于我院接受治疗的102例围绝经期异常子宫出血患者作为受试对象,采用随机数字表法将其分为曼月乐组与地屈孕酮组,每组各51例。地屈孕酮组患者予以宫腔镜联合地屈孕酮治疗,曼月乐组患者予以宫腔镜联合曼月乐治疗。比较两组患者治疗前后的疾病相关指标[子宫内膜厚度、血红蛋白浓度、月经失血图(PBAC)计分]及治疗过程中的不良反应发生率,并记录两组患者随访1年后的远期疗效。结果治疗前,两组患者的子宫内膜厚度、血红蛋白浓度、PBAC计分比较,差异均无统计学意义(P>0.05)。治疗3个月后,两组患者的子宫内膜厚度与PBAC计分均低于本组治疗前,差异有统计学意义(P<0.05),且曼月乐组患者的子宫内膜厚度与PBAC计分低于地屈孕酮组,差异有统计学意义(P<0.05)。治疗3个月后,两组患者的血红蛋白浓度均高于本组治疗前,差异有统计学意义(P<0.05),且曼月乐组患者的血红蛋白浓度高于地屈孕酮组,差异有统计学意义(P<0.05)。曼月乐组患者的阴道点滴出血发生率为15.7%,高于地屈孕酮组的2.0%,差异有统计学意义(P<0.05)。曼月乐组和地屈孕酮组患者的其他不良反应发生率及总发生率比较,差异均无统计学意义(P>0.05)。随访1年后,曼月乐组患者的临床疗效优于地屈孕酮组,且曼月乐组患者的治疗总有效率高于地屈孕酮组,差异有统计学意义(P<0.05)。结论宫腔镜联合曼月乐治疗围绝经期异常子宫出血比地屈孕酮更佳,但易出现阴道点滴出血症状。Objective To explore the clinical application effect of hysteroscopy combined with Dydrogesterone or Mirena in the treatment of perimenopausal abnormal uterine bleeding.Methods A total of 102 patients with perimenopausal abnormal uterine bleeding who were treated in our hospital from January 2016 to June 2018 were selected as study subjects,and they were divided into Mirena group and Dydrogesterone group according to the random number table method,with 51 cases in each group.Dydrogesterone group was given hysteroscopy combined with Dydrogesterone while Mirena group was given hysteroscopy combined with Mirena.The disease-related indexes(endometrial thickness,hemoglobin concentration,pictorial blood loss assessment chart[PBAC]score)before and after treatment and incidence rate of adverse reactions during treatment were compared between the two groups,and the long-term efficacy after 1 year of follow-up was recorded in the two groups.Results Before treatment,there were no significant differences in the endometrial thickness,hemoglobin concentration and PBAC score between the two groups(P>0.05).After 3 months of treatment,the endometrial thickness and PBAC score in the two groups were lower than those before treatment,the difference was statistically significant(P<0.05),and the endometrial thickness and PBAC score in the Mirena group were lower than those in Dydrogesterone group,the differences were statistically significant(P<0.05).After 3 months of treatment,the hemoglobin concentrations in the two groups were higher than those before treatment,the differences were statistically significant(P<0.05),and the hemoglobin concentration in the Mirena group was high than that in Dydrogesterone group,the difference was statistically significant(P<0.05).The incidence rate of vaginal spotting bleeding in Mirena group was 15.7%,which was higher than that in Dydrogesterone group(2.0%),the difference was statistically significant(P<0.05),and there were no statistically significant differences in the incidence rates of other adv

关 键 词：曼月乐 地屈孕酮 围绝经期 疗效 子宫出血 

分 类 号：R977.12[医药卫生—药品]