围绝经期异常子宫出血治疗中曼月乐和安宫黄体酮的效果对照分析

Comparative Analysis of Effects of Mirena and Medroxyprogesterone in the Treatment of Abnormal Uterine Bleeding during Perimenopausal Pe⁃riod

目的调查研究围绝经期异常子宫出血行曼月乐、安宫黄体酮治疗的效果。方法方便选取2020年11月—2021年11月如皋市第三人民医院收治的48例围绝经期异常子宫出血患者为研究对象,按照入选时记录顺序,分为参考组和治疗组,每组24例。参考组行安宫黄体酮治疗,治疗组行曼月乐治疗。需记录两组经期情况,检测性激素状态,观察生化指标及有效性。结果治疗后,两组子宫内膜厚度和月经量均较治疗前减少,且治疗组优于参考组,差异有统计学意义(t=4.460、4.965,P<0.001)。治疗前,两组雌二醇和卵泡刺激素指标比较,差异无统计学意义(t=0.046、0.216,P=0.964、0.830);治疗后,两组雌二醇和卵泡刺激素指标均较治疗前降低,且治疗组比参考组低,差异有统计学意义(t=9.056、4.965,P<0.001)。治疗前,两组血红蛋白和红细胞比容比较,差异无统计学意义(t=0.232、0.191,P=0.818、0.849);治疗后,两组血红蛋白,红细胞比容均较治疗前更高,且治疗组优于参考组,差异有统计学意义(t=3.471、3.182,P=0.001、0.003)。治疗组有效率(95.83%)比参考组(66.67%)高,差异有统计学意义(χ^(2)=4.923,P=0.027)。结论曼月乐能维持更高的有效性,可改善性激素水平,恢复子宫内膜状态,相比安宫黄体酮更建议使用。

Objective To investigate the effect of Mirena and Moxiprogesterone on abnormal uterine bleeding in peri⁃menopausal period.Methods Forty-eight patients with perimenopausal abnormal uterine bleeding admitted to the Third People′s Hospital of Rugao from November 2020 to November 2021 were conveniently selected as the research objects,according to the order of records at the time of inclusion,they were divided into reference group and treatment group,with 24 cases in each group.The reference group was treated with progesterone and the treatment group was treated with Mirena.Menstrual period needs to be recorded,sex hormone status was detected,and biochemical indica⁃tors and effectiveness were observed.Results After treatment,endometrial thickness and menstrual volume decreased in both groups compared with before treatment,and the treatment group was better than the reference group,the differ⁃ence was statistically significant(t=4.460,4.965,P<0.001).Before treatment,estradiol and follicle stimulating hor⁃mone indexes were compared between the two groups,the difference was not statistically significant(t=0.046,0.216,P=0.964,0.830);after treatment,the indexes of estradiol and FSH in two groups decreased,and the treatment group was lower than the reference group,the difference was statistically significant(t=9.056,4.965,P<0.001).Comparison of he⁃moglobin and hematocrit between the two groups before treatment,the difference was not statistically significant(t=0.232,0.191,P=0.818,0.849).After treatment,the hemoglobin and erythrocyte specific volume of the two groups were higher than before treatment,and the treatment group was better than the reference group,the difference was statisti⁃cally significant(t=3.471,3.182,P=0.001,0.003).the effective rate of the treatment group(95.83%)was higher than that of the reference group(66.67%),the difference was statistically significant(χ^(2)=4.923,P=0.027).Conclusion Mi⁃rena can maintain higher effectiveness,improve sex hormones level,and restore the state of the endometrium.It is rec⁃ommended to use it compared to medroxyprogesterone.