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目的探讨屈螺酮炔雌醇片(COC)及左炔诺孕酮宫内缓释系统(LNG-IUS)控制子宫切口憩室致异常子宫出血的效果,初探两者在该疾病应用的前景。方法选取34例在广州市妇女儿童医疗中心妇科门诊诊断为子宫切口憩室致异常子宫出血的患者为研究对象,23例患者采用规范口服COC 6个周期为COC组,11例患者放置LNG-IUS为LNG-IUS组,观察两组患者6个周期内症状控制情况。结果 COC组患者治疗后首次撤退性出血持续时间的缩短较LNG-IUS组有更明显改善;3个周期后两组患者治疗效果差异无统计学意义(P>0.05);6个周期后随访,除去脱落病例外,COC组持续控制症状的效果较LNG-IUS组略为明显,但由于样本量偏小且有脱落病例,不可得出其疗效随着时间延长而更为优越的结论。结论 COC及LNG-IUS在控制子宫切口憩室所致的月经延长均有明显效果,其中COC在更短时间内见明显效果,而对于有长期避孕需求的患者,IUS可在放置3个周期后显现较为稳定的疗效,并在长期治疗花费上更为低廉。
Objective To investigate the effect of drospirenone ethinyl estradiol tablets (COC) and levonorgestrel-releasing intrauterine system (LNG-IUS) in controlling abnormal uterine bleeding in the uterine incision diverticulum and to explore the prospect of their application in this disease. Methods Twenty-four patients with abnormal uterine bleeding caused by uterine incision diverticulum were diagnosed in gynecological outpatient department of Guangzhou Women and Children Medical Center. Sixteen patients were given COC by regular oral COC for 6 cycles and LNG-IUS LNG-IUS group, observe the two groups of patients within 6 cycles of symptom control. Results The duration of first withdrawal bleeding in COC group was significantly shorter than that in LNG-IUS group after treatment. There was no significant difference in therapeutic effect between the two groups after 3 cycles (P> 0.05). After 6 cycles, In addition to shedding cases, COC group continued to control the symptoms of the effect than LNG-IUS slightly more obvious, but because of the small sample size and shedding cases, can not be drawn over its efficacy over time and even more superior conclusion. Conclusions COC and LNG-IUS have significant effects in controlling menstrual prolongation due to uterine incision diverticula. COC has a significant effect in a shorter period of time, and for patients with long-term contraceptive need, IUS can be observed after 3 cycles of placement More stable efficacy, and more cost-effective in long-term treatment.