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目的探讨围绝经期功能失调性子宫出血的诊断体会和米非司酮治疗的临床疗效。方法对商丘市妇幼保健院2010年10至2013年12月确诊为围绝经期功能失调性子宫出血的患者50例,应用米非司酮治疗临床疗效及促卵泡生成素(FSH)、促黄体生成素(LH)、孕酮(P)、泌乳素(PRI)、雌二醇(E2)和子宫内膜厚度的变化的临床资料进行回顾性分析。结果 50例患者在米非司酮治疗期间均出现闭经,停止出血。27例患者直接进入绝经期,20例患者停药2个月后恢复正常月经,3例患者停药6个月后复发。总有效率为94.00%(47/50)。治疗前及治疗后30天、60天、90天经B超测定子宫内膜厚度分别为(1.09±0.19)cm,(0.69±0.15)cm,(0.58±+0.13)cm,(0.51±0.11)cm,治疗前后子宫内膜厚度对比差异有统计学意义(P<0.05)。治疗后FSH、LH、PRL、E2及P水平下降,与治疗前比较差异有统计学意义(P<0.05)。结论米非司酮治疗围绝经期功能失调性子宫出血疗效肯定,不良反应小,而早期正确的诊断是治疗成功的关键。
Objective To investigate the diagnostic experience of peri-menopausal dysfunctional uterine bleeding and the clinical efficacy of mifepristone. Methods 50 cases of patients with dysfunctional uterine bleeding in perimenopausal period diagnosed in Shangqiu MCH from December 2010 to December 2013 were treated with mifepristone for clinical efficacy and follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P), prolactin (PRI), estradiol (E2) and endometrial thickness of the clinical data were retrospectively analyzed. Results All 50 patients underwent amenorrhea during the treatment of mifepristone and stopped bleeding. Twenty-seven patients went straight to menopause. Twenty patients returned to normal menstruation 2 months after discontinuation, and 3 patients relapsed 6 months after withdrawal. The total effective rate was 94.00% (47/50). The thickness of endometrium measured by B ultrasound before treatment and after 30 days, 60 days and 90 days were (1.09 ± 0.19) cm, (0.69 ± 0.15) cm, (0.58 ± +0.13) cm and (0.51 ± 0.11) cm, the difference of endometrial thickness before and after treatment was statistically significant (P <0.05). After treatment, the levels of FSH, LH, PRL, E2 and P decreased, with statistical significance (P <0.05). Conclusion Mifepristone treatment of peri-menopausal dysfunctional uterine bleeding with positive effects, adverse reactions, and the correct diagnosis early is the key to the success of treatment.