炔诺酮联合黄体酮治疗围绝经期异常子宫出血的效果研究

Effect of Norethisterone Combined with Progesterone in the Treatment of Perimenopausal Abnormal Uterine Bleeding

目的:探讨围绝经期异常子宫出血患者采用炔诺酮联合黄体酮治疗的临床效果。方法:选取云南省宣威市第一人民医院2020年1月—2022年12月收治的110例围绝经期异常子宫出血患者,依据计算机法将患者分为对照组和试验组,各55例。两组患者均进行常规刮宫术治疗,对照组术后给予黄体酮治疗,试验组采用黄体酮联合炔诺酮治疗。比较两组患者临床疗效、完全止血时间、控制出血时间、血红蛋白及性激素水平(黄体生成素、雌二醇、促卵泡生成素)。结果:试验组患者治疗总有效率高于对照组,差异有统计学意义(P=0.026)。试验组控制出血时间、完全止血时间短于对照组,差异有统计学意义(P<0.05)。两组患者治疗后,血红蛋白水平均高于治疗前,且试验组高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后,雌二醇水平高于治疗前,促卵泡生成素、黄体生成素低于治疗前,且试验组各项性激素指标水平改善优于对照组,差异有统计学意义(P<0.05)。结论:围绝经期异常子宫出血患者采用黄体酮联合炔诺酮治疗,可在短时间改善异常子宫出血情况,调节患者失血状态以及性激素水平,临床治疗效果显著。

Objective:To investigate the clinical effect of norethisterone combined with progesterone in perimenopausal patients with abnormal uterine bleeding.Methods:A total of one hundred and ten patients with abnormal perimenopausal uterine bleeding admitted to Yunnan Province Xuanwei First People's Hospital from January 2020 to December 2022 were selected and divided into control group and experimental group according to computer method,with fifty-five cases in each group.Both groups were treated with conventional curettage,the control group was treated with progesterone and the experimental group was treated with progesterone combined with norethisterone.The clinical efficacy,complete hemostasis time,bleeding control time,hemoglobin and sex hormone levels(luteinizing hormone,estradiol,follicle-stimulating hormone)were compared between the two groups.Results:The total effective rate of experimental group was higher than that of control group,and the difference was statistically significant(P=0.026);the time to control bleeding and complete hemostasis in experimental group was shorter than that in control group,and the difference was statistically significant(P<0.05);after treatment,the hemoglobin level of both groups was higher than before treatment,and the experimental group was higher than the control group,the difference was statistically significant(P<0.05);after treatment,estradiol level was higher than before treatment,follicle-stimulating hormone and luteinizing hormone were lower than before treatment,and the improvement of various sex hormone indexes in experimental group was better than that in control group,the difference was statistically significant(P<0.05).Conclusion:In perimenopausal patients with abnormal uterine bleeding,progesterone combined with norethisterone can improve abnormal uterine bleeding in a short time,regulate blood loss and sex hormone levels,and the clinical effect is significant.