雌二醇凝胶治疗青春期排卵障碍性异常子宫出血病例的系列研究

A series of studies on estradiol gel in the treatment of adolescent abnormal uterine bleeding-ovulatory dysfunction

目的探讨雌二醇凝胶治疗青春期排卵障碍性异常子宫出血(abnormal uterine bleeding-ovulatory dysfunction,AUB-O)的临床治疗效果及安全性。方法选取成都市妇女儿童中心医院2015年3月至2019年3月收治的合并中重度贫血的青春期AUB-O患者35例,采取经皮雌激素内膜修复法进行治疗。观察治疗后患者的临床疗效、止血情况及平均住院时间,对比治疗前后患者血红蛋白、月经量、子宫内膜厚度变化情况及治疗期间不良反应发生情况。结果治疗后总有效率为88.57%(31/35)。患者的控制出血时间、完全止血时间、快速控制出血率、快速完全止血率分别为(18.38±3.15)h、(44.18±5.09)h、60.00%(21/35)、57.14%(20/35),平均住院(6.81±1.13)d。治疗后患者的血红蛋白水平较治疗前显著升高(P<0.05),月经量较治疗前恢复至正常范围(P<0.05),子宫内膜厚度较治疗前显著增厚(P<0.05),治疗期间不良反应发生率为2.86%(1/35)。结论对青春期AUB-O患者给予雌二醇凝胶治疗能够获得良好的临床治疗效果,达到迅速止血及调整月经周期的目的,且治疗安全性良好。

Objective To investigate the clinical efficacy and safety of estradiol gel in the treatment of abnormal uterine bleeding-ovulatory dysfunction(AUB-O)during puberty.Methods 35 patients with AUB-O during puberty comliacated with moderate to severe anemia treated in Chengdu Women and Children's Central Hospital from March 2015 to March 2019 were selected as the research subjects and treated with percutaneous estrogen endometrial repair.Observed the clinical efficacy,hemostasis and average length of hospitalization of patients after treatment,and compared changes in hemoglobin,menstrual volume,endometrial thickness of patients before and after treatment,and adverse reactions during treatment.Results The total effective rate after treatment was 88.57%(31/35).The controlled bleeding time,complete hemostatic time,rapid controlled bleeding rate,and rapid complete hemostatic rate were(18.38±3.15)h,(44.18±5.09)h,60.00%(21/35),and 57.14%(20/35),the average length of hospital stay were(6.81±1.13)days.After treatment,the hemoglobin(Hb)level of the patients was significantly higher than before treatment(P<0.05),the menstrual volume returned to the normal range(P<0.05),and the endometrial thickness was significantly thicker than before treatment(P<0.05),and the incidence of adverse reactions during the treatment was 2.86%(1/35).Conclusion For patients with AUB-O during puberty,the treatment with estradiol gel can obtain good clinical results,achieve the purpose of rapid hemostasis and adjust the menstrual cycle,and the treatment is safe and worthy of clinical recommendation.