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目的探讨围绝经期功血有效的合理治疗的方法,减少围绝经期功血病人功血反复发生的几率,减轻心理负担,改善此期女性的生活质量。方法选择我科门诊再次因月经紊乱前来就诊的围绝经期功血患者作为治疗对象,共81例。对病情时间长、超声子宫内膜较厚的患者再次给予行妇科超声、子宫内膜检查、宫腔镜检查、血液检查、甲状腺功能等检查以排除器质性病变等引起的月经失调。81例中6例因器质性疾病入院行其他方法治疗,1例因凝血因子缺乏症前往专科治疗。剩余的74例患者随机分为两组,每组各37例。第一组周期性给予妈富隆每日一次口服;另一组给予黄体酮胶囊周期口服。共治疗3个周期,观察两组患者月经周期、经期、经量、药物副作用情况、性生活质量改善等方面的区别。结果口服妈富隆治疗的患者月经周期规律,经量中等,无经间期出血,无明显痛经,2例有较轻的胃肠反应,1例有头痛,30例性生活质量得以明显改善;单纯口服黄体酮治疗的患者中月经周期长短不一发生率较高,经量、经期正常,也无明显痛经,无胃肠反应较重病例,但有经间期淋漓出血患者约12例,性生活无明显改善。结论围绝经期功血是孕激素缺乏的疾病,应用雌孕激素合剂,止血效果更明显,提高患者的依从性,降低复发,同时能改善围绝经妇女的性生活质量。
Objective To investigate the effective treatment of peri-menopausal dysfunctional uterine bleeding and to reduce the recurrence of dysfunctional uterine bleeding during perimenopausal period, reduce the psychological burden and improve the quality of life of women in this period. Methods Select our clinic out of 81 patients with peri-menopausal dysfunctional uterine bleeding due to menstrual disorders. For a long time, ultrasound endometrial thicker patients again given gynecological ultrasound, endometrial examination, hysteroscopy, blood tests, thyroid function tests to rule out organic diseases caused by menstrual disorders. Among the 81 cases, 6 were admitted to hospital due to organic diseases by other methods, and 1 was referred to specialist treatment due to coagulation factor deficiency. The remaining 74 patients were randomly divided into two groups of 37 patients in each group. The first group was given cyclosporine once daily and the other group was given progesterone capsules orally. A total of three cycles were observed, the two groups were observed in the menstrual cycle, menstrual period, by volume, side effects of drugs, sexual quality of life improvement and other differences. Results The treatment of oral Marvelon menstrual cycle in patients with regular menstruation, no menstrual bleeding, no dysmenorrhea, 2 patients had a lighter gastrointestinal reaction, 1 case of headache, 30 cases of quality of life can be significantly improved; simple Oral progesterone treatment in patients with different lengths of the menstrual cycle, the higher the volume, normal menstruation, no obvious dysmenorrhea, no cases of severe gastrointestinal reactions, but there are interim period bleeding dripping about 12 patients, sex life No significant improvement. Conclusion Peri-menopausal dysfunctional uterine bleeding is a disease of progesterone deficiency. The application of estrogen and progesterone combination can make the hemostatic effect more obvious, improve patient compliance, reduce recurrence and improve sexual quality of women in perimenopausal women.