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目的探讨去氧孕烯炔雌醇联合小剂量米非司酮治疗围绝经期功能失调性子宫出血的临床疗效。方法选取2013年9月—2014年6月绛县人民医院收治的围绝经期功能失调性子宫出血患者70例,随机分为观察组与对照组,各35例。对照组患者于诊刮后第5天口服常规剂量米非司酮,观察组患者予以去氧孕烯炔雌醇联合小剂量米非司酮治疗。观察两组患者子宫内膜厚度、性激素〔促卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)〕水平、血红蛋白(Hb)水平、控制出血时间和完全止血时间、不良反应发生情况。结果治疗前两组患者子宫内膜厚度,FSH、LH、E2、Hb水平比较,差异无统计学意义(P>0.05),治疗后观察组患者FSH、LH、E2水平低于对照组,Hb水平高于对照组,子宫内膜厚度小于对照组,差异有统计学意义(P<0.05);两组患者治疗后FSH、LH、E2水平低于治疗前,Hb水平高于治疗前,子宫内膜厚度小于治疗前(P<0.05);观察组控制出血时间、完全止血时间短于对照组(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论去氧孕烯炔雌醇联合小剂量米非司酮治疗围绝经期功能失调性子宫出血的临床疗效显著,能维持血清激素水平平衡,缩短控制出血时间和完全止血时间,且不良反应少,安全性高。
Objective To investigate the clinical efficacy of ethynylestradiol combined with low dose of mifepristone in the treatment of dysfunctional uterine bleeding in perimenopausal period. Methods Seventy patients with peri-menopausal dysfunctional uterine bleeding who were admitted to Jiangxian People’s Hospital from September 2013 to June 2014 were randomly divided into observation group and control group with 35 cases in each group. The patients in the control group were given oral mifepristone on the 5th day after the curettage and the patients in the observation group were treated with the combination of desogestrel ethinyl estradiol and low dose mifepristone. The thickness of endometrium, the levels of sex hormones (FSH, LH, and E2), hemoglobin (Hb) level, bleeding time and complete hemostasis time were observed. Adverse reactions occurred. Results There was no significant difference in endometrial thickness, FSH, LH, E2 and Hb levels between the two groups before treatment (P> 0.05). After treatment, the levels of FSH, LH and E2 in the observation group were lower than those in the control group and Hb level (P <0.05). The levels of FSH, LH and E2 in the two groups were lower than those before treatment and before treatment, the levels of Hb in the two groups were higher than those before treatment, and the endometrium (P <0.05). The bleeding time and the complete bleeding time in the observation group were shorter than those in the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusions The clinical efficacy of DEXEP combined with low dose of mifepristone in treating peri-menopausal dysfunctional uterine bleeding is significant. It can maintain the balance of serum hormone level, shorten the control of bleeding time and complete hemostasis, with less adverse reactions, High security.