左炔诺孕酮宫内节育系统与地屈孕酮分别联合宫腔镜治疗更年期异常子宫出血的效果

Effect of Levonorgestrel Intrauterine System and Dydrogesterone Separate Combined with Hysteroscopy on Abnormal Uterine Bleeding in Menopause

目的探讨左炔诺孕酮宫内节育系统与地屈孕酮分别联合宫腔镜治疗对于更年期异常子宫出血的效果。方法对2020年1月至2022年1月抚州市东乡区中医院择期行宫腔镜下子宫内膜诊刮治疗术治疗的50例更年期异常子宫出血患者进行研究。采取随机数字表法进行分组,两组各25例。对照组在宫腔镜下子宫内膜诊刮治疗术后第15天口服地屈孕酮片治疗。观察组在宫腔镜下子宫内膜诊刮治疗术时为患者放入左炔诺孕酮宫内节育系统。观察疗效、子宫内膜厚度、血红蛋白水平、生活质量评分、促黄体生成激素(LH)、雌二醇(E2)、促卵泡生成激素(FSH)水平、不良反应发生情况。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。干预前观察组和对照组子宫内膜厚度、血红蛋白水平对比,差异无统计学意义(P>0.05);干预后子宫内膜厚度低于干预前,血红蛋白水平高于干预前,数据间对比差异有统计学意义(P<0.05);观察组干预后子宫内膜厚度低于对照组干预后,血红蛋白水平高于对照组干预后,数据间对比差异有统计学意义(P<0.05);观察组生活质量评分高,数据间对比差异有统计学意义(P<0.05)。观察组和对照组干预前LH、E2、FSH水平对比,差异无统计学意义(P>0.05);干预后LH水平高于干预前,数据间对比差异有统计学意义(P<0.05),观察组LH水平高于对照组干预后,数据间对比差异有统计学意义(P<0.05);干预后观察组和对照组E2、FSH水平对比,差异无统计学意义(P>0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论左炔诺孕酮宫内节育系统与地屈孕酮分别联合宫腔镜治疗对于更年期异常子宫出血均有一定的效果,对比来看,左炔诺孕酮宫内节育系统能够更好地改善患者的子宫内膜厚度、血红蛋白水平、生活质量评分、LH水平,提高治疗效果,减少不良反应的发生。

Objective To investigate the effect of levonorgestrel intrauterine system and dydrogesterone combined with hysteroscopy on abnormal uterine bleeding in menopause.Methods From January 2020 to January 2022,50 patients to be accepted in Fuzhou Dongxiang District Hospital of Traditional Chinese Medicine were divided into two groups with 25 cases in each group.Basic treatment:endometrial curettage under hysteroscope.Control group:on the 15th day after basic treatment,the patients were treated with oral dydrogesterone tablets.Observation group:levonorgestrel intrauterine contraceptive system was put into patients during basic treatment.The curative effect,endometrial thickness,hemoglobin level,quality of life score,leuteinizing hormone(LH),estradiol(E2),follicle stimulating hormone(FSH)level and adverse reactions were observed.Results The total effective rate of the observation group was high,and the difference between the data was significant(P<0.05).There was no significant difference in endometrial thickness and hemoglobin level between the observation group and the control group before intervention(P>0.05);after intervention,the endometrial thickness of the observation group and the control group was lower than that before the intervention,and the hemoglobin level was higher than that before the intervention,there was a significant difference between the data(P<0.05).After the intervention,the endometrial thickness of the observation group was lower than that of the control group,and the hemoglobin level was higher than that of the control group,the difference between the data was significant(P<0.05).The quality of life score of the observation group was high,and the difference between the data was significant(P<0.05);there was no significant difference in the levels of LH,E2 and FSH between the observation group and the control group before intervention(P>0.05);the LH level in the observation group and the control group after intervention was higher than that before intervention,and there was significant difference between the data(P<0.05);the LH level in the observation group was higher than that in the control group after the intervention,and there was significant difference between the data(P<0.05).The levels of E2 and FSH in the observation group and the control group were not significantly different before and after the intervention(P>0.05);the total incidence of adverse reactions in the observation group was low,and the difference between the data was significant(P<0.05).Conclusion Levonorgestrel intrauterine contraceptive system and dydrogesterone combined with hysteroscopy have certain effects on abnormal uterine bleeding in menopause.In comparison,levonorgestrel intrauterine contraceptive system can better improve the endometrial thickness,hemoglobin level,quality of life score,LH level,improve the treatment effect and reduce the occurrence of adverse reactions.