摘要目的 分析曼月乐联合米非司酮对围绝经期功血患者子宫内膜厚度与血红蛋白的影响,为临床治疗功血提供依据.方法 选取围绝经期功血患者66例,均为我院妇科2012年10月至2014年10月收治,根据随机数字表法将患者分成两组,每组33例.对照组应用米非司酮治疗,研究组应用米非司酮联合曼月乐治疗,随访观察12个月.对比两组治疗前后月经血量、子宫内膜厚度、血红蛋白水平的变化,并对治疗及随访期间的不良反应及复发率进行观察.结果 ①治疗后,两组PBCA评分均降低,以研究组下降更为显著(P＜0.05);②治疗后,两组子宫内膜均变薄,以研究组变化更为显著(P＜0.05);③治疗后,两组血红蛋白(Hb)水平均上升,以研究组升高更为显著(P＜0.05);④治疗期间,研究组共发生2例(6.1％)不良反应,对照组共发生8例(24.2％)不良反应,组间具有统计学差异(P＜0.05);⑤随访观察期间,研究组复发1例(3.0％),对照组复发6例(18.2％),组间具有统计学差异(P＜0.05).结论 对于围绝经期功血患者,采用曼月乐联合米非司酮治疗可改善出血症状,提高血红蛋白浓度,减少子宫内膜厚度,且不良反应较少,故值得推广应用.

abstractsObjective To analyze the influence of mifepristone combined with Mirena on endometrial thickness and hemoglobin in perimenopausal women with dysfunctional uterine bleeding,and to provide the basis for clinical treatment of dysfunctional uterine bleeding.Methods 66 perimenopausal women with dysfunctional uterine bleeding in department of gynaecology of our hospital from October 2012 to October 2014 were selected and divided into two groups according to the random number table method.33 cases in control group received the treatment of mifepristone,and 33 cases in research group received the treatment of mifepristone combined with Mirena.After 12 months' follow-up,the menstrual blood volume,endometrial thickness,and blood hemoglobin level were compared before and after treatment,and adverse reactions and recurrence rate were observed during treatment and follow-up.Results ①PBCA score of both two groups decreased after treatment,that of study group decreased more significantly (P＜0.05);② the endometrium of both two groups became thinner after treatment,that of study group was much thinner (P＜0.05);③ the hemoglobin (Hb) level of both two groups increased after treatment,that of study group increased more significantly (P＜0.05);④ during the treatment period,there were 2 cases (6.1％) of adverse reactions in study group,and 8 cases (24.2％) in control group,with statistically significant difference between two groups (P＜0.05);⑤during 12 months' follow-up,there were 1 case (3％) of recurrence in study group,and 6 cases (18.2％) in control group,with statistically significant difference between two groups (P＜0.05).Conclusion For patients with perimenopausal dysfunctional uterine bleeding,the treatment method of Mirena combined with mifepristone can improve the symptom of bleeding,increase hemoglobin concentration,reduce the thickness of the endometrium and adverse reactions,so it is worthy of popularization and application.