宫腔镜联合曼月乐治疗异常子宫出血的临床研究

Clinical study of hysteroscopy combined with Mirena in the treatment of abnormal uterine bleeding

目的研究异常子宫出血采用宫腔镜联合左炔诺孕酮宫内节育系统(商品名:曼月乐)治疗的临床效果。方法60例异常子宫出血患者,采用随机数字表法分为对照组和观察组,每组30例。对照组采用宫腔镜下诊刮术治疗,观察组在宫腔镜下诊刮术后放置曼月乐环予以治疗。比较两组患者治疗前后血红蛋白水平、子宫内膜厚度及术后并发症发生情况。结果治疗后,两组患者血红蛋白水平均较本组治疗前升高,且观察组患者血红蛋白水平(95.57±3.32)g/L高于对照组的(84.48±3.05)g/L,差异具有统计学意义(P<0.05)。治疗后,两组患者子宫内膜厚度均较本组治疗前降低,且观察组患者低于对照组,差异具有统计学意义(P<0.05)。观察组患者术后并发症发生率为6.67%,低于对照组的26.67%,差异具有统计学意义(P<0.05)。结论对于异常子宫出血患者,临床上采用宫腔镜联合曼月乐的方案给予治疗可获得确切效果,不仅可提高血红蛋白水平,改善子宫内膜厚度,且并发症发生率更低,兼具有效性和安全性,因此,值得临床进一步推广和应用。

Objective To study the clinical effect of hysteroscopy combined with levonorgestrel intrauterine system(trade name:Mirena)in the treatment of abnormal uterine bleeding.Methods A total of 60 patients with abnormal uterine bleeding were divided into control group and observation group according to random numerical table,with 30 cases in each group.The control group was treated with hysteroscopic curettage,and the observation group was treated with Mirena ring after hysteroscopic curettage.The hemoglobin and endometrial thickness before and after treatment,and occurrence of postoperative complications were compared between the two groups.Results After treatment,the hemoglobin of the two groups were higher than those before treatment,and the observation group[(95.57±3.32)g/L]was higher than the control group[(84.48±3.05)g/L].All the difference was statistically significant(P<0.05).After treatment,the endometrial thickness of the two groups were lower than those before treatment,and the observation group was lower than the control group.All the difference was statistically significant(P<0.05).The incidence of postoperative complications 6.67%of the observation group was lower than 26.67%of the control group,and the difference was statistically significant(P<0.05).Conclusion Combination of hysteroscopy and Mirena has certain effect on patients with abnormal uterine bleeding,and it can improve the hemoglobin and improve the endometrial thickness with low incidence of complications.It is effective and safe,and is worthy of clinical promotion and application.