宫腔镜电切术联合米非司酮治疗围绝经期功能失调性子宫出血 92 例简

目的 探讨宫腔镜电切术联合米非司酮治疗围绝经期功能失调性子宫出血的临床疗效.方法 将2010年6月至2012年6月收治的198例围绝经期功能失调性子宫出血患者分为对照组和观察组,对照组给予宫腔镜子宫内膜电切术治疗,观察组给予宫腔镜子宫内膜电切术联合口服小剂量米非司酮治疗.分别对两组手术情况、疗效、贫血状况、激素水平和不良反应进行评定.结果 两组患者术中出血量、手术时间、膨宫液用量和住院时间比较,差异无统计学意义（P＞0.05）;观察组治疗有效率明显高于对照组（P＜0.05）,治疗后贫血症状较对照组明显改善（P＜0.05）;治疗前后血清卵泡雌激素（FSH）、黄体生成素（LH）、雌二醇（E2）和孕酮（P）等激素水平对照组患者无明显变化（P＞0.05）,观察组患者治疗后较治疗前有所下降,但差异无统计学意义（P＞0.05）;两组并发症发生率比较无统计学意义（P＞0.05）.结论 宫腔镜子宫内膜电切术联合米非司酮治疗围绝经期功能失调性子宫出血疗效显著、安全,值得临床推广.

Transcervical Resection of Endometrium Combined with Mifepristone in Treating Perimenopausal Dysfunctional Uterine Bleeding in 92 Cases

Objective To explore the clinical efficacy of transcervical resection of the endometrium combined with mifepristone in treating perimenopausal dysfunctional uterine bleeding.Methods One hundred and ninety-eight patients with perimenopausal dysfunctional uterine bleeding admitted to our hospital from June 2011 to June 2012 were divided into the control group and the observation group.The control group was treated with transcervical resection of the endometrium.The observation group was given transcervical resection of the endometrium combined with postoperative small dose of oral mifepristone.The operation situation,clinical efficacy,anemia,sex hormones levels and adverse reactions were evaluated in the two groups.Results There was no statistical differences in the intraoperative bleeding volume,operation time,used volume of cavity-distention media and hospitalization duration between the control group and the observation group（P 〉 0.05）.The effective rate in the observation group was higher than that in the control group（P 〈 0.05）.The anemia symptoms in the observation group were significantly improved than those in the control group（P〈0.05）.The sex hormones （FSH,LH,E2 and P） before and after treatment in the control group had no changes（P〉0.05）,while which in the observation group were decreased to some extent,but without statistical difference（P 〉 0.05）.The complications occurrence rate in the two groups showed no statiotical significance （P〉 0.05）.Conclusion Transcervical resection of the endometrium combined with mifepristone has significant effect and safety in treating perimenopause dysfunctional uterine bleeding,which is worthy of clinical promotion.