曼月乐与宫腔镜下子宫内膜电切术治疗顽固性功能失调性子宫出血的对比研究

Comparative Study on Mirena and Transcervical Resection of the Endometrium in the Treatment of Intractable Dysfunctional Uterine Bleeding

目的:观察曼月乐治疗顽固性功能失调性子宫出血的临床效果。方法:回顾性分析40例诊断为功能失调性子宫出血并已生育的患者,予正规孕激素治疗后效果欠佳又拒绝切除子宫者为研究对象,根据患者知情选择分为研究组和对照组,研究组23例予宫内放置曼月乐治疗,对照组17例接受宫腔镜下子宫内膜电切除术治疗,观察两组患者治疗后子宫内膜厚度变化、月经量改变和不良反应。结果:研究组患者子宫内膜从治疗后第3个月开始明显变薄,月经量逐渐减少;对照组多数患者术后3个月内子宫内膜稍有变薄,月经量有所改善,但不如研究组明显,而且多数患者治疗后数月子宫内膜又开始增厚;治疗后的不良反应发生率研究组明显低于对照组。结论:曼月乐治疗顽固性功能失调性子宫出血是一种安全有效、方便经济的方法,值得临床推广使用。

Objective ：To observe the clinical effect of Mirena therapy for intractable dysfunctional uterine bleeding.Methods ：To retrospectively analyse the clinical datas of 40 cases of patients who had already given births and were diagnosed as dysfunctional uterine bleeding, had not responded well to progestin therapy and had refused hysterectomy. Informed about the therapy or not, these patients were divided into study group and control group.23 patients in the study group were treated with Mirena therapy in their uterus ; while the other 17 patients in the control group accepted transcervical resection of the endometrium.To observe the post treatment status of those patients, in terms of change of thickness of endometrium and menstrual quantity, as well as adverse reaction.Reslllts .＇In the study group, their endometrium became significantly thinner and menstrual quantity gradually reduced within 3 months since the therapy ; To most of the control group, their endometrium became a little bit thinner and menstrual quantity became a little bit better within 3 months after the operation ~ but not as significantly as those of study group, and their endometrium became thick again several months after the operation.The rate of adverse reaction of study group was significantly lower than that of the control group.Conclusion ：Mirena therapy is safe and effective, convenient and economical, worthy clinical promotion.