去氧孕烯炔雌醇片与左炔诺孕酮节育系统在排卵障碍性异常子宫出血治疗中的应用

The application value of desogestrel combined with ethinylestradiol tablets and mirena IUD for treating patients with abnormal uterine bleeding because of ovulatory disorders

目的:比较去氧孕烯炔雌醇片与左炔诺孕酮节育系统治疗排卵障碍性异常子宫出血的临床效果。方法:选取2015年11月-2017年11月本院收治的排卵障碍性异常子宫出血患者88例,以随机数字表法分为对照组和观察组各44例。对照组给予去氧孕烯炔雌醇片治疗,观察组给予曼月乐治疗,观察两组治疗效果,月经失血图(PBAC)评分、血红蛋白(Hb)水平、子宫内膜厚度、性激素水平变化及不良反应发生情况。结果:观察组治疗总有效率(95.5%)高于对照组(81.8%)(P<0.05);两组治疗前PBAC评分、Hb水平、子宫内膜厚度及性激素水平对比无差异(P>0.05),治疗后两组均有改善,且观察组Hb水平高于同期对照组,PBAC评分、子宫内膜厚度及血清雌二醇(E_2)、促黄体生成素(LH)、促卵泡激素(FSH)水平低于同期对照组(P<0.05);不良反应发生率观察组(6.8%)低于对照组(22.7%)(P<0.05)。结论:相比于去氧孕烯炔雌醇片,曼月乐治疗排卵障碍性异常子宫出血效果更为确切,可更有效改善症状,调节性激素水平,且具有较好的安全性。

Objective:To compare the clinical effects of desogestrel combined with ethinylestradiol tablets and mirena intrauterine device(IUD)for treating patients with abnormal uterine bleeding because of ovulatory disorders.Methods:88 patients with abnormal uterine bleeding because of ovulatory disorders admitted to Huludao central hospital from November 2015 to November 2017 were selected as the study subjects,and they were randomly divided into control group and observation group(44 cases in each group).The patients in control group were treated by desogestrel combined with ethinylestradiol tablets,and the patients in observation group were treated by mirena IUD.The treatment effects,the changes of pictorial blood loss assessment chart(PBAC)score,hemoglobin(Hb)level,endometrial thickness,sex hormone level,and the incidence of adverse reaction of patients in the two groups were observed.Results:The total effective rate of patients in observation group(94.45%)was significant higher than that of patients(81.82%)in control group(P<0.05).There was no significant difference in the PBAC score,Hb level,endometrial thickness,sex hormone level of patients between the two groups before treatment(P>0.05),but the PBAC score,Hb level,endometrial thickness,sex hormone level of patients in boths groups had improved after treatment.After treatment,the Hb level of patients in observation group was significant higher than that of patients in control group,but PBAC score,endometrial thickness,and the levels of serum estradiol(E 2),luteinizing hormone(LH),follicle stimulating hormone(FSH)of patients in observation group were significant lower than those of control group(P<0.05).The incidence of adverse reactions of observation group(94.45%)was significant lower than that(81.82%)of patients in control group(P<0.05).Conclusion:Compared to desogestrel combined with ethinylestradiol tablets,mirena IUD has higher effective for patients with abnormal uterine bleeding because of ovulatory disorders,which can improve symptoms,regulate sex hormone levels,and has higher safety.