左炔诺孕酮宫内节育系统联合醋酸甲地孕酮治疗围绝经期异常子宫出血患者的效果观察  

Observation on the efficacy of levonorgestrel intrauterine system combined with megestrol acetate in the treatment of perimenopausal abnormal uterine bleeding patients

作　　者：陈人花 CHEN Ren-hua(Gynecology Department,Fuzhou Second General Hospital Maternal and Child Health Hospital,Fuzhou 350007,China)

机构地区：[1]福州市第二总医院妇幼保健院妇科,350007

出　　处：《中国现代药物应用》2024年第9期103-106,共4页Chinese Journal of Modern Drug Application

摘　　要：目的观察左炔诺孕酮宫内节育系统(LNG-IUS)联合醋酸甲地孕酮治疗围绝经期异常子宫出血患者的效果。方法122例围绝经期异常子宫出血患者,通过双盲黑白双色球法随机分为常规组(61例)和联合组(61例)。常规组给予宫腔镜电切术治疗,联合组在常规组基础上术后采用LNG-IUS联合醋酸甲地孕酮治疗。比较两组临床疗效、康复情况、性激素水平、并发症发生情况和复发情况。结果联合组的总有效率(96.72%)较常规组(78.69%)更高(P<0.05)。治疗3个月后,两组月经失血图(PBAC)评分、子宫内膜厚度均较术前显著降低,且联合组较常规组更低;月经时间均较术前显著缩短,且联合组较常规组更短;血红蛋白水平均较术前显著提高,且联合组较常规组更高(P<0.05)。治疗3个月后,两组卵泡刺激素(FSH)、雌二醇(E_(2))、黄体生成素(LH)、睾酮(T)水平均较术前显著降低,且联合组较常规组更低(P<0.05)。联合组并发症发生率(3.28%)较常规组(19.67%)更低(P<0.05);随访6个月后,联合组复发率(4.92%)较常规组(22.95%)更低(P<0.05)。结论围绝经期异常子宫出血患者应用LNG-IUS联合醋酸甲地孕酮治疗效果明显,可显著改善患者康复情况、并发症发生情况和复发情况,降低性激素水平。Objective To observe the efficacy of levonorgestrel intrauterine system(LNG-IUS)combined with megestrol acetate in the treatment of perimenopausal abnormal uterine bleeding patients.Methods 122 patients with perimenopausal abnormal uterine bleeding were randomly divided into a conventional group(61 cases)and a combined group(61 cases)using a double-blind black and white dichroism method.The conventional group was treated with hysteroscopic resection,while the combined group was treated with LNG-IUS combined with megestrol acetate based on the conventional group.The clinical efficacy,recovery,levels of sex hormones,occurrence of complications,and recurrence were compared between the two groups.Results The total effective rate of the combined group(96.72%)was higher than that of the conventional group(78.69%)(P<0.05).After 3 months of treatment,the pictorial blood loss assessment chart(PBAC)score and endometrial thickness in both groups were significantly lower than those before surgery,and the combined group was lower than the conventional group;the menstrual duration in both groups was significantly shorter than that before surgery,and the combined group was shorter than the conventional group;the hemoglobin level in both groups was significantly higher than that before surgery,and the combined group was higher than the conventional group(P<0.05).After 3 months of treatment,the levels of follicle-stimulating hormone(FSH),estradiol(E_(2)),luteinizing hormone(LH)and testosterone(T)in both groups were significantly lower than those before surgery,and the combined group were lower than the conventional group(P<0.05).The incidence of complications of the combined group(3.28%)was lower than that of the conventional group(19.67%)(P<0.05).After 6 months of followup,the recurrence rate of the combined group(4.92%)was lower than that of the conventional group(22.95%)(P<0.05).Conclusion The combination of LNG-IUS and megestrol acetate has a significant therapeutic effect on patients with perimenopausal abnormal uterine blee

关 键 词：左炔诺孕酮宫内节育系统 醋酸甲地孕酮 异常子宫出血 性激素 

分 类 号：R711[医药卫生—妇产科学] R969[医药卫生—临床医学]