论文部分内容阅读
目的观察连续口服小剂量米非司酮3个月治疗围绝经期功能失调性子宫出血的临床疗效。方法68例围绝经期功能失调性子宫出血患者诊断性刮宫后每天给予米非司酮12.5mg口服,1次/d,连服3个月。用药前后及用药期间查血常规和肝肾功能。并于治疗前后分别测定血中FSH、LH、E2、P的含量,B超探查子宫体积和子宫内膜厚度变化,观察患者月经情况,注意有无不良反应。结果治疗前测定血中FSH、LH、E2、P的含量分别为(21.1±11.3)U/L、(18.4±4.7)U/L、(66.86±26.3)pmol/L、(0.87±0.31)nmol/L,治疗后血中FSH、LH、E2、P的含量分别为(10.2±5.1)U/L、(9.8±3.5)U/L、(45.23±17.31)pmol/L、(0.52±0.14)nmol/L。治疗后血中4种激素的含量明显低于治疗前(P<0.05)。68例围绝经期功能失调性子宫出血患者用药期间全部闭经,总有效率100%,其中有7例直接进入绝经期,43例停药后平均47d恢复月经,经量正常。另外18例月经稀发量少。贫血患者血红蛋白上升或恢复正常。68例治疗期间及治疗后肝肾功能正常,9例出现轻度恶心,停药后消失,14例轻度潮热、出汗。治疗前后B超探察子宫体积缩小,治疗前(143.82±30.2)cm3,治疗后(113.40±18.4)cm3,P<0.05。子宫内膜变薄,治疗前(8.2±0.4)mm,治疗后(4.0±0.2)mm,P<0.05。结论连续口服小剂量米非司酮3个月治疗围绝经期功能失调性子宫出血疗效可靠,不良反应小,具有较高的临床治疗价值。
Objective To observe the clinical efficacy of continuous oral low dose mifepristone for 3 months in the treatment of dysfunctional uterine bleeding in perimenopausal period. Methods Sixty-eight patients with dysfunctional uterine bleeding during peri-menopausal period were given oral mifepristone 12.5 mg orally once daily for 3 months after the diagnosis of curettage. Before and after treatment and check the blood routine and liver and kidney function. The levels of FSH, LH, E2 and P in blood were measured before and after treatment. The changes of uterine volume and endometrial thickness were examined by B-mode ultrasonography. The menstrual status was observed and the adverse reactions were observed. Results The levels of FSH, LH, E2 and P in the blood were (21.1 ± 11.3) U / L, (18.4 ± 4.7) U / L and (66.86 ± 26.3) pmol / / L, respectively, and the levels of FSH, LH, E2 and P in the blood after treatment were (10.2 ± 5.1) U / L, 9.8 ± 3.5 U / L, 45.23 ± 17.31 pmol / L and 0.52 ± 0.14, nmol / L. After treatment, the content of 4 hormones in blood was significantly lower than before treatment (P <0.05). 68 cases of menopausal dysfunctional uterine bleeding in patients with medication during amenorrhea, the total efficiency of 100%, of which 7 cases directly into the menopause, 43 cases after stopping an average of 47d to resume menstruation, the normal amount. Another 18 cases of menstrual thin hair less. Hemoglobin in anemic patients rises or returns to normal. 68 patients during and after treatment of liver and kidney function was normal, mild nausea occurred in 9 cases, disappeared after stopping, 14 cases of mild hot flashes, sweating. Before and after treatment, the size of the uterus of B ultrasound exploration was reduced, before treatment (143.82 ± 30.2) cm3, after treatment (113.40 ± 18.4) cm3, P <0.05. Endometrial thinning, before treatment (8.2 ± 0.4) mm, after treatment (4.0 ± 0.2) mm, P <0.05. Conclusion Continuous low-dose oral administration of mifepristone for 3 months to treat dysfunctional uterine bleeding in peri-menopausal period has reliable curative effect and small adverse reactions, and has high clinical value.