邓斌荣

[摘要] 目的 探讨根据B超监测子宫内膜厚度个性化选择药物治疗无排卵型功能失调性子宫出血的临床效果。 方法 选择2012年1月1日～2015年1月31日在我院门诊就诊的无排卵型功能失调性子宫出血患者156例，以子宫内膜厚度8 mm为界限分为两组：A组62例，内膜厚度<8 mm，选择雌孕激素联合治疗；B组94例，内膜厚度≥8 mm，选择单纯孕激素治疗，此组又根据出血量和血红蛋白（Hb）值分为两组：B1组58例，为急性出血且量多和阴道出血淋漓但Hb<70 g/L两类患者，选择孕激素内膜萎缩法；B2组36例，为阴道出血淋漓患者，选择内膜转化法。止血后后续调整月经周期，方案：所有患者选择治疗周期撤药出血的第5天开始口服去氧孕烯炔雌醇1粒/次，1次/d，连用21 d为1个周期，连续使用3个周期并观察效果。临床疗效以止血成功率、调经有效率为观察指标。 结果 止血方面：A组的止血成功率100.00%，B组为94.68%，两组的止血成功率比较，差异无统计学意义（χ2=3.14，P>0.05）；调经方面：A组的有效率为100.00%，B组为96.81%，两组的调经有效率比较，差异无统计学意义（χ2=2.16，P>0.05）。 结论 B超监测子宫内膜厚度个性化选择药物治疗无排卵型功能失调性子宫出血的方案具有良好的临床效果，此方法简便、合理、经济、创伤小，值得基层临床推广。

[关键词] B超；子宫内膜厚度；药物治疗；无排卵型功能失调性子宫出血

[中图分类号] R711.52 [文献标识码] A [文章编号] 1674-4721（2016）02（b）-0077-04

Analysis of B ultrasound combined with drug treating anovulatory dysfunctional uterine bleeding

DENG Bin-rong

Suichuan Population and Family Planning Service Center in Jiangxi Province，Suichaun 343900，China

[Abstract] Objective To explore the clinical effect of personalized selecting drug to treat anovulatory dysfunctional uterine bleeding according to B ultrasound monitoring endometrial thickness. Methods 156 patients with anovulatory dysfunctional uterine bleeding from January 1，2012 to January 31，2015 treated by outpatient in our hospital were selected.Patients were divided into two groups according to the boundary of endometrial thickness 8 mm：62 cases in group A （endometrial thickness<8 mm） and patients were given estrogenic combined with progesterone hormone；94 cases in group B （endometrial thickness≥8 mm） and patients were given simply progesterone.Group B was further divided into two groups according to the bleeding volume and Hb value：58 cases in group B1，and patients had large acute bleeding and vaginal bleeding profusely but Hb<70 g/L，and they were given progesterone endometrium atrophy；36 cases in group B2，and patients had vaginal bleeding profusely and they were given endometrial transformation method.Subsequent method for adjustment menstrual cycle after hemostasis：on the fifth day of treatment cycle withdrawal bleeding， all patients were treated with oral desogestrel，1 tablet one time and once a day for sustained 21 days as a course.Sustained for using 3 courses and then the effect were observed.Success rate of hemostasis，effective rate of regulating menstruation were selected as observation index for clinical effect. Results On the aspect of hemostasis：hemostasis success rate in group A was 100.00% and 94.68% in group B，and the difference between two groups had no statistical significance （χ2=3.14，P>0.05）.On the aspect of regulating menstruation：the effective rate in group A was 100.00% and 96.81% in group B，and the difference between two groups had no statistical significance （χ2=2.16，P>0.05）. Conclusion Individually selecting drug treating anovulatory dysfunctional uterine bleeding according to B ultrasound monitoring endometrial thickness has better therapy effect and with advantages of easy，reasonable，economy and little trauma.It is worth to popularize in primary clinic.

[Key words] B ultrasound；Endometrial thickness；Drug treatment；Anovulatory dysfunctional uterine bleeding

功能失调性子宫出血简称“功血”，是常见的一种妇科疾病，临床表现为月经周期不规律、月经量过多或淋漓不尽，给女性生活和工作带来不便，甚至导致严重贫血等，造成精神困扰，严重影响妇女的身心健康。功血治疗主要原则包括止血和调整月经周期两大方面。药物治疗是青春期功血患者的首选，而围绝经期功血的止血治疗可选择诊断性刮宫术，诊断性刮宫对于围绝经期功血患者能达到快速止血的目的，也是确诊子宫内膜病变的主要手段，但是因为不能改变下丘脑-垂体系统对血清激素水平的调节而容易导致功血复发[1]，且诊断性刮宫术属于有创性操作，可增加患者的痛苦，不宜反复进行，故药物治疗仍是治疗围绝经期功血的一线治疗方案。如何……