戊酸雌二醇联合黄体酮序贯治疗青春期功能失调性子宫出血临床观察

Effect of Estradiol Valerate Combined with Progesterone in Sequential Treatment of Dysfunctional Uterine Bleeding in Adolescence

目的:观察戊酸雌二醇联合黄体酮序贯治疗对青春期功能失调性子宫出血患者激素水平、贫血情况及子宫内膜厚度的影响。方法:选取2018年5月至2020年1月期间于新乡医学院第一附属医院接受治疗的74例青春期功能失调性子宫出血患者,按照随机数字表法分为联合组和常规组,各37例。联合组患者采用戊酸雌二醇序贯联合黄体酮进行治疗,常规组单用戊酸雌二醇治疗,治疗时间为3个月经周期。观察两组患者控制出血时间、完全止血时间差异,记录治疗前及治疗3个月经周期后两组患者血清性激素[黄体生成素(LH)、卵泡雌激素(FSH)、雌二醇(E2)],统计治疗期间两组患者药物不良反应发生情况。结果:联合组患者控制出血时间、完全止血时间均显著短于常规组,差异具有统计学意义(P<0.05)。治疗3个月经周期后,两组患者LH、FSH、E2水平均较治疗前显著降低,且联合组显著低于常规组,差异均具有统计学意义(P<0.05)。治疗期间,两组患者恶心、呕吐、头痛、乳房胀痛等药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论:戊酸雌二醇序贯联合黄体酮治疗青春期功能失调性子宫出血效果良好,可明显改善患者贫血情况,调整机体内分泌环境,减少子宫内膜厚度,对其预后恢复有利。

Objective To observe the effects of sequential therapy of estradiol valerate combined with progesterone on hormone levels,anemia and endometrial thickness in patients with adolescent dysfunctional uterine bleeding.Methods A total of 74 adolescent patients with dysfunctional uterine bleeding treated in the First Affiliated Hospital of Xinxiang Medical College from May 2018 to January 2020 were selected and divided into combined group(37 cases)and conventional group(37 cases)according to random number table method.The combined group received sequential estradiol valerate combined with progesterone,while the conventional group received estradiol valerate alone for 3 menstrual cycles.The differences of bleeding control time and complete hemostasis time between 2 groups were observed,serum sex hormones(LH,FSH and E2)were recorded before treatment and 3 menstrual cycles after treatment,and the incidence of adverse drug reactions in two groups during treatment was statistically analyzed.Results The bleeding control time and complete hemostasis time in combined group were significantly shorter than those in conventional group,with statistical significance(P<0.05).After 3 menstrual cycles,the levels of LH,FSH and E2 in two groups were significantly lower than before,and the levels of LH,FSH and E2 the combined group was significantly lower than those in the conventional group,the differences were statistically significant(P<0.05).During treatment,there was no significant difference in the incidence of adverse drug reactions such as nausea,vomiting,headache and breast tenderness between two groups(P>0.05).Conclusion Estradiol valerate sequentially combined with progesterone has a good effect on the treatment of adolescent dysfunctional uterine bleeding,which can obviously improve the anemia of patients,adjust the endocrine environment of the body,reduce endometrial thickness,and is beneficial to the recovery of prognosis.