米非司酮与去氧孕烯炔雌醇片对围绝经期功能性子宫出血患者子宫内膜厚度的影响及疗效观察

摘要

目的：观察米非司酮与去氧孕烯炔雌醇片对围绝经期功能性子宫出血患者子宫内膜厚度的影响及疗效。方法：选取围绝经期功能性子宫出血患者70例，随机分为观察组和对照组。观察组患者在刮宫术后5d开始口服米非司酮连用3个月。对照组患者在刮宫术后5d开始口服去氧孕烯炔雌醇片连用3个月。观察两组患者治疗前后子宫内膜厚度的变化，并比较其临床疗效及安全性。结果：治疗3个月后，两组患者子宫内膜厚度均较前明显变薄（P＜0.05或P＜0.01），且观察组较对照组变薄更明显（P＜0.05）；治疗后随访6个月，两组患者的临床总有效率比较差异无统计学意义（χ2＝0.27，P＞0.05）。治疗中对照组和观察组分别发生6例和5例不良反应，症状均较轻，两组不良反应发生率比较无明显统计学差异（χ2＝0.11， P＞0.05）。结论：米非司酮与去氧孕烯炔雌醇片治疗围绝经期功能性子宫出血患者均具有较好疗效及安全性，且前者对子宫内膜增生抑制更明显，适用于年龄较大妇女；而后者恢复正常月经周期率高，适用于较年轻有避孕要求的妇女。%To observe the influence and curative effect of Mifepristone and Desogestrel and Ethinylestradiol Tablets on endometrial thickness of patients with dysfunctional uterine bleeding during peri-meno-pausal period.Methods:70 patients with dysfunctional uterine bleeding during peri-menopausal period were se-lected and divided into observation group and control group randomly.The patients in observation group were given Mifepristone orally 5 days after the uterine curettage for 3 months,while the patients in control group were given Desogestrel and Ethinylestradiol Tablets orally 5 days after the uterine curettage for 3 months.The changes of endo-metrial thickness of patients in two groups after the medical treatment were observed and clinical curative effect and security were compared as well.Results:After 3 months’medical treatment,the endometrial thickness of patients in two groups were obviously thinner (P<0.05 or P<0.01 ),and the extent of thinning in observation group was much more obvious than that it in control group (P<0.05 ).According to the 6 months’following-up after the medical treatment,the total clinical efficiency of patients in two groups had no statistical differences (χ2 =0.27, P>0.05).6 and 5 cases of untoward effect appeared in control group and observation group in the medical treat-ment respectively,with light symptom.The occurrence rates of untoward effect of the two group had no statistical differences (χ2 =0.11,P>0.05).Conclusion:Mifepristone and Desogestrel and Ethinylestradiol Tablets have fa-vorable curative effect and security on patients with dysfunctional uterine bleeding during peri-menopausal period, and the former has much more obvious inhibitory action on hyperplasia endometrium,which is suitable for older women;while the latter has high rate of returning to normal menstrual cycle rate,which is suitable for younger women with contraceptive requirement.