醋酸甲羟孕酮联合左炔诺孕酮宫内节育系统在围绝经期异常子宫出血治疗中的应用  

Application of medroxyprogesterone acetate combined with levonorgestrel intrauterine contraceptive system in the treatment of abnormal uterine bleeding during perimenopause

作　　者：周爱龙 万玉珍[1] ZHOU Ailong;WAN Yuzhen(Dept.of Gynaecology,Jiangxi Maternal and Child Health Hospital,Nanchang 330006,Jiangxi,China)

机构地区：[1]江西省妇幼保健院妇科,江西南昌330006

出　　处：《武汉大学学报(医学版)》2025年第3期386-391,共6页Medical Journal of Wuhan University

基　　金：江西省卫生健康委科技计划资助项目(编号:202211081)。

摘　　要：目的:探讨醋酸甲羟孕酮联合左炔诺孕酮宫内节育系统(LNG-IUS)治疗围绝经期异常子宫出血的疗效。方法:选取江西省妇幼保健院收治的120例围绝经期异常子宫出血患者,使用随机数字表法分为3组(各40例),A组口服醋酸甲羟孕酮片,B组采用LNG-IUS治疗,C组联合应用醋酸甲羟孕酮和LNG-IUS治疗。观察3组治疗前后的月经情况、子宫内膜厚度、性激素水平及贫血指标变化,对比治疗效果、不良反应发生率等。结果:相比治疗前,3组治疗后的子宫内膜厚度变薄,月经量减少,经期时间缩短,血清FSH、LH及E2水平下降(P<0.05)。组间对比显示,C组的子宫内膜厚度明显比另外两组更薄,月经量比另外两组更少,经期时间比另外两组更短,血清FSH、LH、E2水平比另外两组更低,差异有统计学意义(P<0.05)。A组与B组的子宫内膜厚度、月经量、经期时间、血清FSH、LH及E2水平接近(P>0.05)。3组治疗后的血红蛋白、红细胞比容水平均较治疗前明显升高(P<0.05),并且C组的血红蛋白、红细胞比容水平显著高于另外两组(P<0.05)。C组的总有效率为95.00%,显著高于A组的75.00%和B组的72.50%(P<0.05),A组与B组的总有效率比较差异无统计学意义(P>0.05)。3组的不良反应发生率接近(P>0.05)。结论:醋酸甲羟孕酮联合LNG-IUS治疗围绝经期异常子宫出血,可有效调节患者的性激素水平,降低子宫内膜厚度,减少出血,其治疗效果显著,且无明显不良反应。Objective:To explore the efficacy of medroxyprogesterone acetate combined with levonorgestrel intrauterine contraceptive system(LNG-IUS)in the treatment of abnormal uterine bleeding during perimenopause.Methods:A total of 120 patients with abnormal uterine bleeding during perimenopause admitted to Jiangxi Maternal and Child Health Hospital were randomly divided into three groups(n=40)by a random number table method.Group A received oral medroxyprogesterone acetate tablets,Group B received LNG-IUS treatment,and Group C received a combination of medroxyprogesterone acetate and LNG-IUS treatment.The changes in menstrual status,endometrial thickness,sex hormone levels,and anemia indicators before and after treatment in three groups were observed,and the treatment effect and incidence of adverse reactions were compared among the three groups.Results:After treatment,the endometrial thickness of the three groups decreased,menstrual volume decreased,menstrual period time shortened,and serum FSH,LH,and E2 levels decreased after treatment(P<0.05).The inter-group comparison showed that the endometrial thickness of Group C was significantly thinner than the other two groups,with fewer menstrual cycles and shorter menstrual periods compared to the other two groups.The serum levels of FSH,LH,and E2 were lower than the other two groups,and the difference was statistically significant(P<0.05).The endometrial thickness,menstrual volume,menstrual duration,serum FSH,LH,and E2 levels in Group A and Group B were similar(P>0.05).After treatment,the levels of hemoglobin and hematocrit in all three groups were significantly higher than before treatment(P<0.05),and the levels of hemoglobin and hematocrit in Group C were significantly higher than those in the other two groups(P<0.05).The total effective rate of Group C was 95.00%,which was significantly higher than 75.00%in Group A and 72.50%in Group B(P<0.05).There was no statistically significant difference in the total effective rate between Group A and Group B(P>0.05).The incidence of

关 键 词：醋酸甲羟孕酮 左炔诺孕酮宫内节育系统 围绝经期 异常子宫出血 子宫内膜厚度 

分 类 号：R711.52[医药卫生—妇产科学]