左炔诺孕酮宫内释放系统与炔雌醇环丙孕酮片治疗围绝经期功能失调性子宫出血的疗效比较

摘要

Objective To compare the clinical effects of Mirena and Diane-35 on peri-menopausal dys-functional uterine bleeding.Methods Total of 80 patients with peri-menopausal dysfunctional uterine bleeding admitted to Jiangyin People′s Hospital from Mar.2012 to Mar.2014 were included in the study, and divided into two groups by random table method:the observation group(40 cases) was treated with Mire-na placed at the 4th-7th days of menstruation,and was followed up for 6 months;the control group(40 cases) was treated with Diane-35,since 5-7 days after diagnostic curettage,1 pill per day,for 21 days,waiting for the fifth days after withdrawal bleeding then re-started taking for 3 consecutive months.The vaginal bleeding con-trol time and clinical effect of the two groups were compared.Results Bleeding control time of the observa-tion group was longer than the control group[(30.2 ±4.3) h vs (19.8 ±3.4) h],and complete hemostasis time was longer than the control group[(53.1 ±3.3) h vs (34.5 ±2.6) h],the differences were statistical-ly significant(P <0.01).Total effective rate of the observation group was higher than the control group (100.0% vs 75.0%),the difference was statistically significant(P <0.05).The recurrence rate of the observation group was lower than the control group(2.5%vs 35.0%),the difference was statistically signifi-cant( P<0.05 ) .Conclusion Effocts of Mirena and Diane-35 on peri-menopausal dysfunctional uterine bleeding are significant,while Diane-35 is better than Mirena in time of bleeding control,and Mirena is better than Diane-35 in cure rate and recurrence rate.%目的：比较左炔诺孕酮宫内释放系统和炔雌醇环丙孕酮片治疗围绝经期妇女功能失调性子宫出血（功血）的临床疗效。方法选择2012年3月至2014年3月就诊于江阴市人民医院妇科的围绝经期功血患者80例，依据随机数字表法分为两组，各40例。观察组采用左炔诺孕酮宫内释放系统治疗，于月经第4～7日放置，随访6个月；对照组采用炔雌醇环丙孕酮片治疗，诊断性刮宫后5～7 d起，每日1片，连续应用21 d，等待撤退性出血后第5日重新开始服用，连续服用3个月。比较两组患者控制阴道出血的时间和临床疗效。结果观察组控制出血时间和完全止血时间分别为（30.2±4.3） h、（53.1±3.3） h，长于对照组的（19.8±3.4） h、（34.5±2.6） h，差异有统计学意义（P＜0.01）。观察组总有效率显著高于对照组（100.0％比75.0％），差异有统计学意义（P＜0.05）；观察组复发率低于对照组（2.5％比35.0％），差异有统计学意义（P＜0.05）。结论左炔诺孕酮宫内释放系统与炔雌醇环丙孕酮片治疗围绝经期功血均疗效显著，控制出血时间方面炔雌醇环丙孕酮片优于左炔诺孕酮宫内释放系统，但在治愈率和复发率方面，左炔诺孕酮宫内释放系统优于炔雌醇环丙孕酮片。