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目的对无排卵性功能失调性子宫出血患者进行左炔诺孕酮宫内缓释系统治疗,探讨左炔诺孕酮宫内缓释系统对无排卵性功能失调性子宫出血的治疗效果。方法选择2011年10月-2014年10月南浔区人民医院妇产科门诊收治的无排卵性功能失调性子宫出血患者100例,将其随机平均分为左炔诺孕酮宫内缓释系统组(观察组)和对照组,观察组子宫内放置左炔诺孕酮宫内缓释系统治疗,对照组给予妈富隆治疗,观察两组治疗前后月经量、血红蛋白含量、激素水平、肝功能、血脂和不良反应情况。结果两组治疗后月经量评分均明显少于治疗前(P<0.05),治疗后血红蛋白含量均明显高于治疗前(P<0.05);治疗后观察组月经量评分低于对照组(P<0.05),治疗后观察组血红蛋白含量高于对照组(P<0.05)。对照组治疗后孕酮(P)和雌二醇(E2)水平较治疗前低(P<0.05),对照组治疗后P和E_2水平低于观察组(P<0.05)。观察组治疗后低密度脂蛋白、甘油三酯和胆固醇较治疗前降低(P<0.05),高密度脂蛋白较治疗前升高(P<0.05);对照组治疗后低密度脂蛋白和胆固醇较治疗前升高(P<0.05),观察组治疗后低密度脂蛋白、高密度脂蛋白、甘油三酯和胆固醇与对照组比较差异均有统计学意义(P<0.05)。观察组点滴出血的发生率高于对照组(P<0.05),其他不良反应的发生率均低于对照组(P<0.05)。结论左炔诺孕酮宫内缓释系统治疗无排卵性功能失调性子宫出血的疗效比较显著,能够有效减少月经量,对肝功能和血脂没有不良影响,其主要不良反应为点滴出血。
Objective To investigate the treatment effect of levonorgestrel-releasing intrauterine system on anovulatory dysfunctional uterine bleeding in patients with anovulatory dysfunctional uterine bleeding. Methods 100 patients with anovulatory dysfunctional uterine bleeding admitted to Obstetrics and Gynecology Clinic of People’s Hospital of Nanxun District from October 2011 to October 2014 were randomly divided into levonorgestrel intrauterine system group (Observation group) and control group. The observation group was treated with levonorgestrel intrauterine release system in the uterus. The control group was given Marvelon treatment. The menstrual flow, hemoglobin content, hormone level, liver function, blood lipid And adverse reactions. Results The scores of menstrual flow in both groups were significantly lower than those before treatment (P <0.05), and the levels of hemoglobin in the two groups were significantly higher than those before treatment (P <0.05). After treatment, the menstrual scores in the observation group were lower than those in the control group (P < 0.05). After treatment, the hemoglobin content of the observation group was higher than that of the control group (P <0.05). The levels of progesterone (P) and estradiol (E2) in the control group were lower than those before treatment (P <0.05), while the levels of P and E_2 in the control group were lower than those in the control group (P <0.05). After treatment, the levels of LDL, triglyceride and cholesterol in the observation group decreased (P <0.05) and the levels of HDL in the control group increased (P <0.05). The levels of LDL-C and cholesterol The levels of LDL, HDL, triglyceride and cholesterol in the observation group were significantly different from those in the control group before treatment (P <0.05). The incidence of drip bleeding in observation group was higher than that in control group (P <0.05), and the incidence of other adverse reactions was lower than that in control group (P <0.05). Conclusion Levonorgestrel-releasing intrauterine system for the treatment of anovulatory dysfunctional uterine bleeding is more effective and can effectively reduce the amount of menstrual flow, and has no adverse effect on liver function and blood lipids. The main adverse reaction is drip bleeding.