宫腔镜联合地屈孕酮与曼月乐在治疗围绝经期异常子宫出血中的临床应用效果比较

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摘要目的探讨宫腔镜联合地屈孕酮与曼月乐在治疗围绝经期异常子宫出血中的临床应用效果。方法选取2016年1月～2018年6月于我院接受治疗的102 例围绝经期异常子宫出血患者作为受试对象，采用随机数字表法将其分为曼月乐组与地屈孕酮组，每组各51 例。地屈孕酮组患者予以宫腔镜联合地屈孕酮治疗，曼月乐组患者予以宫腔镜联合曼月乐治疗。比较两组患者治疗前后的疾病相关指标[子宫内膜厚度、血红蛋白浓度、月经失血图（PBAC）计分]及治疗过程中的不良反应发生率，并记录两组患者随访1年后的远期疗效。结果治疗前，两组患者的子宫内膜厚度、血红蛋白浓度、PBAC 计分比较，差异均无统计学意义（P＞0.05）。治疗3 个月后，两组患者的子宫内膜厚度与PBAC 计分均低于本组治疗前，差异有统计学意义（P＜0.05），且曼月乐组患者的子宫内膜厚度与PBAC 计分低于地屈孕酮组，差异有统计学意义（P＜0.05）。治疗3 个月后，两组患者的血红蛋白浓度均高于本组治疗前，差异有统计学意义（P＜0.05），且曼月乐组患者的血红蛋白浓度高于地屈孕酮组，差异有统计学意义（P＜0.05）。曼月乐组患者的阴道点滴出血发生率为15.7%，高于地屈孕酮组的2.0%，差异有统计学意义（P＜0.05）。曼月乐组和地屈孕酮组患者的其他不良反应发生率及总发生率比较，差异均无统计学意义（P＞0.05）。随访1年后，曼月乐组患者的临床疗效优于地屈孕酮组，且曼月乐组患者的治疗总有效率高于地屈孕酮组，差异有统计学意义（P＜0.05）。结论宫腔镜联合曼月乐治疗围绝经期异常子宫出血比地屈孕酮更佳，但易出现阴道点滴出血症状。

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	宋云静
	黄俊

关键词 ：曼月乐, 地屈孕酮, 围绝经期, 疗效, 子宫出血

Abstract：Objective To explore the clinical application effect of hysteroscopy combined with Dydrogesterone or Mirena in the treatment of perimenopausal abnormal uterine bleeding. Methods A total of 102 patients with perimenopausal abnormal uterine bleeding who were treated in our hospital from January 2016 to June 2018 were selected as study subjects, and they were divided into Mirena group and Dydrogesterone group according to the random number table method, with 51 cases in each group.Dydrogesterone group was given hysteroscopy combined with Dydrogesterone while Mirena group was given hysteroscopy combined with Mirena.The disease-related indexes (endometrial thickness,hemoglobin concentration, pictorial blood loss assessment chart [PBAC]score) before and after treatment and incidence rate of adverse reactions during treatment were compared between the two groups, and the long-term efficacy after 1 year of follow-up was recorded in the two groups. Results Before treatment, there were no significant differences in the endometrial thickness, hemoglobin concentration and PBAC score between the two groups (P＞0.05).After 3 months of treatment, the endometrial thickness and PBAC score in the two groups were lower than those before treatment, the difference was statistically significant (P＜0.05), and the endometrial thickness and PBAC score in the Mirena group were lower than those in Dydrogesterone group, the differences were statistically significant (P＜0.05).After 3 months of treatment, the hemoglobin concentrations in the two groups were higher than those before treatment, the differences were statistically significant (P＜0.05), and the hemoglobin concentration in the Mirena group was high than that in Dydrogesterone group, the difference was statistically significant (P＜0.05).The incidence rate of vaginal spotting bleeding in Mirena group was 15.7%, which was higher than that in Dydrogesterone group (2.0%), the difference was statistically significant (P＜0.05), and there were no statistically significant differences in the incidence rates of other adverse reactions and the total incidence (P＞0.05).After 1 year of follow-up, the clinical efficacy of the Mirena group was better than that of the Diquprogesterone group, and the total effective rate of the Mirena group was higher than that of the Diquprogesterone group, with statistically significant differences (P＜0.05).Conclusion Hysteroscopy combined with Mirena is better than Dydrogesterone in the treatment of menopausal dysfunctional uterine bleeding, and it is prone to vaginal spotting bleeding symptoms

Key words： Mirena Dydrogesterone Perimenopausal Efficacy Uterine bleeding

基金资助:江西省赣州市科技计划项目

作者简介: 宋云静（1973-），汉族，江苏人，本科，副主任医师，研究方向：普通妇科及妇科内分泌研究

引用本文:

宋云静; 黄俊. 宫腔镜联合地屈孕酮与曼月乐在治疗围绝经期异常子宫出血中的临床应用效果比较[J]. 中国当代医药, 2020, 27(15): 126-129.
SONG Yun-jing; HUANG Jun. Clinical application effect comparison of hysteroscopy combined with Dydrogesterone or Mirena in the treatment of perimenopausal abnormal uterine bleeding. 中国当代医药, 2020, 27(15): 126-129.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I15/126

[1]	辛路平，蒋清清.不同方案治疗围绝经期功血的效果与安全性[J].中国性科学，2019，28（7）：106-109.
[2]	陈凤.炔雌醇环丙孕酮与LNG-IUS 治疗围绝经期功血效果观察[J].中国计划生育学杂志，2019，27（1）：36-39.
[3]	李娟彬.中西医结合治疗围绝经期功能性子宫出血临床观察[J].现代中西医结合杂志，2014，23（11）：1178-1179.
[4]	张曼，赵俊，王娟.地屈孕酮联合宫腔镜电切对保留生育功能的早期子宫内膜癌患者的影响[J].中国性科学，2019，28（6）：30-32.
[5]	袁华.曼月乐联合妈富隆治疗围绝经期功血的临床疗效及对血清FSH、LH、E2、P 水平的影响[J].标记免疫分析与临床，2018，25（11）：1666-1669.
[6]	中华医学会妇产科学分会内分泌学组中华医学会妇产科学分会绝经学组.功能失调性子宫出血临床诊断治疗指南（草案）[J].中华妇产科杂志，2009，44（3）：234-236.
[7]	杨江华，张丹丹，高琴，等.宫腔镜子宫内膜射频消融术治疗围绝经期功血疗效观察[J].中国性科学，2016，25（11）：36-38.
[8]	冯力民，夏恩兰，黄晓武，等.应用月经失血图评估月经血量[J].中华妇产科杂志，2001，36（1）：51.
[9]	中华医学会妇产科学分会绝经学组.围绝经期异常子宫出血诊断和治疗专家共识[J].中华妇产科杂志，2018，53（6）：396-401.
[10]	杨九红.宫腔镜下子宫内膜电切术治疗围绝经期功血临床效果及对内分泌激素的影响[J].河南医学研究，2016，25（7）：1294-1295.
[11]	王丽，朱红英，张群昌.宫腔镜联合曼月乐手术治疗子宫内膜息肉疗效观察[J].陕西医学杂志，2019，48（7）：920-922.
[12]	常惠，孙林，邵小光，等.地屈孕酮预处理及黄体支持对PCOS 患者促排卵结局的影响[J].生殖医学杂志，2017，26（2）：138-142.
[13]	刘菊红，唐世倩，褚春芳，等.宫腔镜电切术联合曼月乐环治疗复发性子宫内膜息肉的效果分析[J].解放军预防医学杂志，2019，37（7）：63-65.
[14]	李华淑，王清津，潘许花，等.曼月乐和米非司酮治疗围绝经期功血的疗效比较[J].中华全科医学，2013，11（8）：1211-1212.
[15]	徐晓颖，尤静洁.曼月乐治疗子宫腺肌症的临床疗效和安全性分析[J].中国妇幼保健，2017，32（13）：2876-2878.