去氧孕烯炔雌醇、地屈孕酮分别联合戊酸雌二醇治疗青春期排卵障碍性异常子宫出血的疗效  

Efficacy of Desogestrel/Ethinyl estradiol or Dydrogesterone combined with Estradiol valerate in the treatment of adolescent abnormal uterine bleeding-ovulatory dysfunction

作　　者：于雪 王秀云 杨秀萍 唐华 YU Xue;WANG Xiu-yun;YANG Xiu-ping;TANG Hua(Department of Obstetrics and Gynecology,Yancheng Dafeng People's Hospital,Yancheng 224100,Jiangsu,China)

机构地区：[1]盐城市大丰人民医院妇产科,江苏盐城224100

出　　处：《川北医学院学报》2024年第12期1628-1631,共4页Journal of North Sichuan Medical College

基　　金：江苏省科学技术项目(BK20201211)。

摘　　要：目的:比较去氧孕烯炔雌醇、地屈孕酮分别联合戊酸雌二醇治疗青春期排卵障碍性异常子宫出血(AUB-O)的临床疗效。方法:纳入95例青春期AUB-O患者为研究对象,按照干预方式不同将其分为A、B两组。A组接受去氧孕烯炔雌醇联合戊酸雌二醇治疗(n=48);B组接受地屈孕酮联合戊酸雌二醇治疗(n=47)。以1个月经周期为1个疗程,两组患者均连续治疗3个疗程。比较两组患者治疗前后止血情况、临床疗效、性激素水平、卵巢血流动力学参数及不良反应发生情况。结果:两组患者控制出血时间、完全止血时间比较,差异均无统计学意义(P>0.05)。B组患者临床有效率97.87%,高于A组的83.33%(P<0.05)。治疗后,两组患者血清促卵泡生成激素(FSH)、黄体生成素(LH)、雌二醇(E2)比较,差异均无统计学意义(P>0.05);B组患者搏动指数(PI)、收缩期峰值流速(PSV)均高于A组(P<0.05),阻力指数(RI)低于A组(P<0.05)。B组患者不良反应总发生率为8.51%,低于A组的27.08%(P<0.05)。结论:去氧孕烯炔雌醇、地屈孕酮分别联合戊酸雌二醇治疗青春期AUB-O的止血效果及性激素改善情况相当,但地屈孕酮联合戊酸雌二醇临床疗效及安全性更优,且有利于改善卵巢血流动力学参数。Objective:To investigate the efficacy of Desogestrel/Ethinyl estradiol or Dydrogesterone combined with Estradiol valerate in the treatment of adolescent abnormal uterine bleeding-ovulatory dysfunction(AUB-O).Methods:95 adolescent AUB-O patients were included as the research subjects and divided into A and B groups according to the different intervention methods.Group A(n=48)received treatment with Desogestrel/Ethinyl estradiol combined with Estradiol valerate,while group B(n=47)received treatment with Dydrogesterone combined with Estradiol valerate.With 1 menstrual cycle as 1 course of treatment,both groups of patients were treated for 3 consecutive courses The hemostasis,clinical efficacy,sex hormone levels,ovarian hemodynamic parameters,and incidence of adverse reactions before and after treatment were compared between the two groups.Results:There w as no statistically significant difference in the control of bleeding time and complete hemostasis time between the two groups of patients(P>0.05).The clinical effective rate of group B patients was 97.87%,which was higher than group A s 83.33%(P<0.05).After treatment,there was no statistically significant difference in serum follicle stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E 2)levels between the two groups of patients(P>0.05).The pulsatility index(PI)and peak systolic velocity(PSV)of patients in group B were higher than those in group A(P<0.05),while the resistance index(RI)was lower(P<0.05).The total incidence of adverse reactions in group B patients was 8.51%,which was lower than group A s 27.08%(P<0.05).Conclusion:The hemostatic effect and sex hormone improvement of adolescent AUB-O treated with Desogestrel/Ethinyl estradiol or Dydrogesterone combined with Estradiol valerate are comparable.The combination of Dydrogesterone and Estradiol valerate has better clinical efficacy,improved ovarian hemodynamic parameters.

关 键 词：去氧孕烯炔雌醇 地屈孕酮 戊酸雌二醇 排卵障碍性异常子宫出血 性激素 卵巢动力学 

分 类 号：R711.52[医药卫生—妇产科学]