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目的探讨雌孕激素联合疗法治疗青春期功能性子宫出血的疗效及安全性。方法选择2016年2月-2017年2月延安大学咸阳医院妇科收治的青春期功能性子宫出血患者98例为研究对象,采用随机数表法分为对照组和观察组,每组各49例。对照组仅给予雌激素治疗,即口服戊酸雌二醇,4 mg/次,6~8 h服药1次,出血控制后逐渐减少药物剂量至2 mg/d,并维持2 mg/d的药量直至止血停止后20 d;观察组给予雌孕激素联合疗法治疗,即戊酸雌二醇18 mg/d,出血得到控制后逐步减量1 mg/d维持至止血停止后20 d,同时服用安宫黄体酮8 mg/次,3次/d,出血得到控制后逐步减量至6 mg/d维持至止血停止后20 d。对比两组患者临床疗效、止血效果及不良反应的发生情况。结果观察组患者速效率和总有效率显著高于对照组,且观察组患者均在7 d内成功止血;观察组患者控制出血时间和完全止血时间显著短于对照组;观察组患者不良反应发生率低于对照组,差异均有统计学意义(均P<0.05)。结论雌孕激素联合疗法治疗青春期功能性子宫出血的临床效果显著,可有效改善患者止血效果和月经调整效果,且不良反应少。
Objective To investigate the efficacy and safety of combined estrogen and progesterone therapy in the treatment of adolescent dysfunctional uterine bleeding. Methods From February 2016 to February 2017, 98 cases of adolescent functional uterine bleeding treated by gynecology and gynecology in Yan Yang Hospital of Yan’an University were divided into control group and observation group with 49 cases in each group. The control group was given only estrogen therapy, namely, orally administered estradiol valerate 4 mg once daily for 6-8 hours. After the bleeding control, the dosage of estradiol was gradually reduced to 2 mg / d and the dosage of 2 mg / d The amount of estradiol valerate was 18 mg / d. After the bleeding was controlled, the dosage was reduced gradually by 1 mg / d until 20 d after the stop of hemostasis, while the patients in the observation group were given estradiol and progesterone combined therapy. Angestine progesterone 8 mg / time, 3 times / d, after bleeding was gradually reduced to 6 mg / d until the stop bleeding after 20 d. The clinical efficacy, hemostatic effect and adverse reactions of the two groups were compared. Results The observation group was significantly faster than the control group and the total effective rate was significantly higher than the control group, and the observation group patients were successfully hemostasis within 7 d; observation group patients control bleeding time and complete bleeding time was significantly shorter than the control group; patients in the observation group adverse reactions The rate was lower than the control group, the difference was statistically significant (P <0.05). Conclusion The combination of estrogen and progesterone in the treatment of functional dysfunctional uterine bleeding in adolescents has a significant clinical effect, which can effectively improve the effect of hemostasis and menstrual adjustment in patients with less adverse reactions.