戊酸雌二醇联合屈螺酮炔雌醇片治疗无排卵性异常子宫出血患者的临床效果及对血红蛋白水平的影响

Clinical effect of estradiol valerate combined with drospirenone ethinylestradiol tablets in the treatment of patients with anovulatory abnormal uterine bleeding and its influence on hemoglobin level

目的分析戊酸雌二醇联合屈螺酮炔雌醇片治疗无排卵性异常子宫出血患者的临床效果。方法选择2020年1月至2021年12月收治的94例无排卵性异常子宫出血患者,通过随机数字表法将其分为单药组(n=47,屈螺酮炔雌醇片治疗)和双药组(n=47,戊酸雌二醇+屈螺酮炔雌醇片治疗)。比较两组的治疗效果。结果双药组的治疗总有效率高于单药组,1年内复发率低于单药组(P<0.05);两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。治疗后,两组的血红蛋白(Hb)水平及红细胞比容(HCT)高于治疗前,子宫内膜厚度小于治疗前,且双药组优于单药组(P<0.05)。治疗后,两组的月经失血图(PBAC)评分低于治疗前,且双药组低于单药组(P<0.05);双药组的完全止血时间短于单药组(P<0.05)。结论戊酸雌二醇联合屈螺酮炔雌醇片治疗无排卵性异常子宫出血患者可获得显著效果,有助于改善子宫内膜厚度、Hb水平及HCT,减少月经失血量,缩短完全止血时间,且未增加不良反应。

Objective To analyze the clinical effect of estradiol valerate combined with drospirenone ethinylestradiol tablets in the treatment of patients with anovulatory abnormal uterine bleeding.Methods A total of 94 patients with anovulatory abnormal uterine bleeding admitted from January 2020 to December 2021 were selected and divided into single drug group(n=47,drospirenone ethinylestradiol tablets treatment)and double drug group(n=47,estradiol valerate+drospirenone ethinylestradiol tablets treatment)by random number table method.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the double drug group was higher than that in the single drug group,and the recurrence rate within 1 year was lower than that in the single drug group(P<0.05);there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).After treatment,the hemoglobin(Hb)level and hematocrit(HCT)in the two groups were higher than those before treatment,the endometrial thickness was smaller than that before treatment,and those in the double drug group were better than the single drug group(P<0.05).After treatment,the score of Pictorial Blood Loss Assessment Chart(PBAC)in the two groups was lower than that before treatment,and that in the double drug group was lower than the single drug group(P<0.05);the complete hemostasis time of the double drug group was shorter than that of the single drug group(P<0.05).Conclusion Estradiol valerate combined with drospirenone ethinylestradiol tablets in the treatment of patients with anovulatory abnormal uterine bleeding can obtain significant effect,help to improve endometrial thickness,Hb level and HCT,reduce menstrual blood loss,shorten complete hemostasis time,and do not increase adverse reactions.