摘要
目的探讨采用去氧孕烯炔雌醇(妈富隆)联合小剂量米非司酮治疗围绝经期功能性子宫出血患者的临床疗效。方法选择2019年3月至2020年4月在我服务中心进行治疗的围绝经期功能性子宫出血患者64例为研讨对象,根据入院先后顺序,将其分为对照组(n=32)和研究组(n=32)。对照组接受刮宫治疗,在刮宫之后的第3天予以去氧孕烯炔雌醇片,每日1次,1次1片,连续口服21 d,停药7 d之后为1个疗程,总共3个疗程。治疗期间观察患者的出血情况及出血量,对患者随时调整用药。研究组接受诊断性刮宫之后的第3天开始接受米非司酮每日1次,每次10 mg,30 d为1个疗程。其余的治疗方案与对照组一致。观察并分析两组患者出血时长、控制出血时长,两组患者在治疗前后的血清激素水平,治疗3个疗程之后的子宫内膜厚度和临床疗效。结果研究组止血时长及控制出血时长分别为(74.45±13.05)h、(9.95±3.73)h,对照组分别为(86.13±17.87)h、(14.47±5.65)h,研究组止血时长及控制出血时长均显著低于对照组,差异有统计学意义(t=3.8063、4.8144,P均<0.05)。两组患者在进行子宫治疗前,子宫内膜的厚度无差异(P>0.05),治疗后和本组患者在治疗前对比,子宫内膜厚度显著减少(P<0.05),但研究组子宫内膜厚度比对照组减少的程度更明显且差异有统计学意义(P<0.05)。研究组的治疗总有效率96.15%(50/52),明显高于对照组84.62%(44/52),差异有统计学意义(χ^(2)=7.6486,P<0.05)。结论对围绝经期功能性子宫出血患者使用去氧孕烯炔雌醇片与小剂量的米非司酮进行联合治疗,可降低子宫内膜的厚度,安全性较高,治疗效果明显。
Objective To investigate the clinical efficacy of desogestrel ethinyl estradiol(Marvelon)combined with low-dose mifepristone in the treatment of perimenopausal functional uterine bleeding.Methods Sixty-four patients with perimenopausal functional uterine bleeding who were treated in our hospital between March 2019 and April 2020 were selected as the research objects.According to the order of admission,they were divided into a control group and a study group.There were 32 persons in each group.The control group received curettage for treatment.Desogestrel ethinyl estradiol tablets were given on the 3 d after curettage,once a day,1 tablet at a time,for 21 consecutive days,and after stopping the drug for 7 days,there was 1 course of treatment and 3 courses in total.During the treatment,observe the patient's bleeding and the amount of bleeding,and adjust the medication at any time for the patient.The study group began to receive mifepristone once a day on the 3 d after receiving diagnostic curettage,10 mg each time,30 days as a course of treatment.The rest of the treatment plan is consistent with the control group.Observe and analyze the bleeding time and control bleeding time of the two groups of patients.The serum hormone levels of the two groups of patients before and after treatment,the endometrial thickness after 3 courses of treatment,and the clinical curative effect were compared.Results The duration of hemostasis and control of bleeding in the study group were(74.45±13.05)h and(9.95±3.73)h,respectively,and the control group were(86.13±17.87)h,(14.47±5.65)h.The researcher group was significantly lower than the control group and the difference was statistically significant(t=3.8063,4.8144,all P<0.05).Before the treatment of the uterus,the thickness of the endometrium between the two groups of patients was no statistically significant(P>0.05).After the treatment,the thickness of the endometrium was significantly reduced(P<0.05).The endometrial thickness of the study group was more significantly reduced than that of the control group,and the difference was statistically significant(P<0.05),the total effective rate of treatment in the study group was 96.15%(50/52),which was significantly higher than 84.62%(44/52)in the control group,the difference was statistically significant(χ^(2)=7.6486,P<0.05).Conclusion For patients with perimenopausal functional uterine bleeding,the combined treatment of desogestrel and ethinyl estradiol tablets and small doses of mifepristone can reduce the thickness of the endometrium,with high safety and obvious therapeutic effects.
作者
李素贞
LI Suzhen(Hekou District Maternal and Child Health and Family Planning Service Center of Dongying,Dongying 257200,China)
出处
《中国医药指南》
2021年第11期16-18,共3页
Guide of China Medicine
关键词
功能性子宫出血
围绝经期
去氧孕烯炔雌醇
Functional uterine bleeding
Perimenopausal period
Desogestrel ethinyl estradiol
