雌激素或避孕药治疗青春期功能性子宫出血的效果分析

目的探讨雌激素及避孕药治疗青春期功能性子宫出血(功血)的止血效果和适宜的起始剂量。方法对我院1990年2月至2005年7月治疗的106例的临床资料进行回顾性分析。结果本组106例中采用苯甲酸雌二醇(E2)组56例,口服结合雌激素(CEE)组30例,口服避孕药(COCs)组20例。快速控制出血率和快速止血率CEE组与E2组相比有显著延长,COCs与E2组效果相似。控制出血时间和完全止血时间E2起始剂量≤8 mg/d组和>8 mg/d组相比无显著差异;CEE起始剂量<7.5 mg/d与≥7.5 mg/d组相比也无显著差异,但需加量治疗率明显增加;COCs(妈富隆)≤3片/d与>3片/d组相比也无显著差异。结论用COCs治疗青春期功血在控制出血方面效果与E2的效果类似。增加上述各药的剂量,并不增强其止血效果。

A retrospective study on estrogen or contraceptives in the treatment of dysfunctional uterine bleeding in adolescent patients

Objective: To investigate the clinical efficacy of estrogen or contraceptives in the treatment of acute bleeding episode of dysfunctional uterine bleeding(DUB) in adolescent patients and the optimal starting dosage of the drugs.Methods: The clinical records of 106 girls with DUB and moderate or severe anemia from February 1990 to July 2005 were retrospectively analyzed.Results: All 106 patients received hormonal therapy.Fifty six patients were treated with estradiol benzoate(E_2),30 patients with conjugated equine estrogen(CEE) and 20 patients with combined oral(contraceptives)(COCs).The rates of rapidly controlling bleeding and the rates of rapidly stopping bleeding in E_2 group were higher than those in CEE group and were similar to those in COCs group.The different starting dosages(≤8 mg/d and >8 mg/d in E_2 group,<7.5 mg/d and ≥7.5 mg/d of CEE group,≤3 pills/d and >3 pills/d of COCs group) showed no difference in the time intervals for controlling bleeding and for completely stopping bleeding,but during the treatment with CEE,the rate of increasing the dosage in <7.5 mg/d group was higher than that in ≥7.5 mg/d group(40% vs.6%).Conclusions: The clinical efficacy of E_2 on DUB in adolescent patients is similar to that of COCs.And the efficacies of E_2,CEE and COCs at different dosages are similar.