地屈孕酮治疗围绝经期功能失调性子宫出血临床研究

Clinical Research on Dydrogesterone in Treatment of Dysfunctional Uterine Bleeding during the Perimenopause Period

目的研究围绝经期功能失调性子宫出血(功血)患者采用地屈孕酮治疗的临床效果分析。方法临床纳入106例该院2014年4月—2016年4月妇科收治的围绝经期功血患者作为研究对象。根据随机数字表法分为两组各53例。其中53例患者采用米非司酮治疗作为对照组,另53例患者给予地屈孕酮治疗作为观察组。观察两组患者治疗效果、止血效果、性激素水平及不良反应。结果观察组治疗总有效率高达96.23%,高于对照组的84.91%,(P<0.05)。控制出血时间及完全止血时间上,观察组为(24.79±4.96)h、(8.62±3.74)d,相对于对照组的(36.28±5.65)h、(13.26±4.83)d时间更短(P<0.05)。治疗前两组患者子宫内膜厚度、血红蛋白浓度以及性激素水平差异无统计学意义(P>0.05);治疗后观察组子宫内膜厚度、血红蛋白浓度及性激素水平分别为(4.14±0.83)mm、(119.12±13.07)g/L、(6.42±1.14)U/L、(5.86±2.13)umol/L以及(43.97±4.62)U/L,优于对照组的(6.59±1.06)mm、(110.24±12.64)g/L、(11.43±1.58)U/L、(12.15±2.09)umol/L以及(29.56±2.89)U/L(P<0.05)。观察组不良反应发生率仅7.55%,低于对照组的16.98%(P<0.05)。结论地屈孕酮对围绝经期功血治疗效果显著,缩短止血时间,改善性激素水平,不良反应少,值得临床应用及推广。

Objective To re se a rch th e c l in ic a l effect of d yd roge sterone in tre a tm en t of dys fu nc tio n al u te r in e b leeding dur ing the perimenopause period. Methods 106 c a se s of p a t ien ts d u r in g th e p e rim en op au se period adm it ted an d trea ted in our hospi tal from Apr il 2014 to Apr il 2016 were selected and randomly divided into two groups with 53 cases in each, the control group and the observation group were respectively treated with mifepris tone and dydrogesterone, and the treatment effect, hemostatic effect, sex hormone level and adverse reactions of the two groups were observed. Re-sults The total treatment effective rate in the observation group was higher than that in the control group （96.23% vs 84.91%）,（P〈0.05）, and the bleeding control time and complete hemostasis time in the observation group were shorter than those in the control group[（24.79±4.96）h,（8.62±3.74）d vs （36.28±5.65）h, （13.26±4.83）d], （P〈0.05）, before treat-ment, there were no differences in the endometrial thickness , hemoglobin concentrat ion, and sex hormone levels be-tween the two groups （P〉0.05）, af ter treatment, the endometrial thickness , hemoglobin concentrat ion, and sex hormone levels in the observation group were bet ter than those in the control group [ （4.14±0.83）mm,（119.12±13.07）g/L, （6.42± 1.14）U/L, （5.86±2.13）umol /L,（43.97±4.62）U/L vs （6.59±1.06）mm,（110.24±12.64）g/L,（11.43±1.58）U/L,（12.15±2.09）umol/ L,（29.56±2.89）U/ L]（ P〈0.05）,and the incidence rate of adverse reactions in the observation group was lower than that in the control group, （7.55% vs 16.98%）,（P〈0.05）. Conclusion The effect of dydrogesterone in treatment of dys-functional uterine bleeding during the perimenopause period is obvious, which can shorten the hemostasis time and im-prove the sex hormone level with fewer adverse reactions, and it is worth clinical application and promotion.