去氧孕烯炔雌醇与地屈孕酮治疗青春期排卵障碍性异常子宫出血的效果观察

目的观察去氧孕烯炔雌醇与地屈孕酮对青春期排卵障碍性异常子宫出血(AUB-O)的疗效。方法回顾性分析丽水市人民医院妇产科2017年1月至2019年9月治疗的青春期AUB-O患者113例临床资料,患者根据治疗方案不同分为去氧孕烯炔雌醇组(58例)和地屈孕酮组(55例),观察两组患者治疗效果。结果去氧孕烯炔雌醇组患者血量减少1/2时间、完全血止时间均显著短于地屈孕酮组(t值分别为3.568、3.125,均P<0.05)。两组患者调整月经周期第一疗程月经正常率比较差异均无统计学意义(χ^2=2.562,P>0.05),去氧孕烯炔雌醇组调整月经周期第二疗程和第三疗程月经正常率均显著低于地屈孕酮组(χ^2值分别为6.444、6.482,均P<0.05)。两组患者人工周期治疗后血清FSH、LH水平与治疗前比较均有所下降,但治疗前后血清FSH、LH、E2水平比较差异均无统计学意义(t值0.132~1.135,均P>0.05)。结论去氧孕烯炔雌醇治疗青春期AUB-O止血时间短,但地屈孕酮不影响青春期生殖轴调控,月经规律和排卵恢复优于去氧孕烯炔雌醇,临床应用时应根据患者具体情况而定。

Effects of desogestrel ethinyl estradiol and dydrogesterone on abnormal uterine bleeding with ovulatory dysfunction in adolescence

Objective To observe the effects of desogestrel ethinyl estradiol and dydrogesterone in the treatment of abnormal uterine bleeding with ovulatory dysfunction(AUB-O)in adolescence.Methods The clinical data of 113 adolescent patients with AUB-O treated in the Department of Obstetrics and Gynecology of Lishu People’s Hospital from January 2017 to September 2019 were retrospectively analyzed.The patients were divided into the desogestrel ethinyl estradiol group(58 cases)and the dydrogesterone group(55 cases).The treatment effects of the two groups were observed.Results The time of blood volume decreased by 1/2 and complete blood stop in the desogestrel ethinyl estradiol group were significantly shorter than those in the dydrogesterone group(t=3.568 and 3.125,respectively,bothP<0.05).There was no significant difference in the normal rate of the first course of menstrual cycle adjustment between the two groups(χ^2=2.562,P>0.05).The normal rates of the second and third course of menstrual cycle adjustment in the desogestrel ethinyl estradiol group were significantly lower than those in the dydrogesterone group(χ^2=6.444 and 6.482,respectively,both P<0.05).After artificial cycle treatment,the serum levels of FSH and LH in the two groups were decreased compared with those before treatment,but there were no statistically significant differences in the serum levels of FSH,LH and E2 before and after treatment(t=0.132~1.135,all P>0.05).Conclusion The duration of AUB-O hemostasis in the treatment of adolescent patients with desogestrel ethinyl estradiol is shorter than dydrogesterone,but dydrogesterone does not affect the regulation of adolescent reproductive axis,and menstrual regularity and ovulation recovery are better than that of desogestrel ethinyl estradiol.Clinical application should be based on the specific conditions of patients.