徐晓琳 俞力微

[摘要] 目的 探讨醋酸甲羟基孕酮联合抗生素治疗子宫内膜炎的临床效果。 方法 将2013年6月～2014年12月我院收治的80例子宫内膜炎患者随机分为对照组（40例）和观察组（40例），观察组采用醋酸甲羟基孕酮片联合抗生素治疗，对照组采用抗生素治疗，比较两组的临床疗效、月经情况和治疗前后细胞因子水平变化情况。 结果 观察组的总有效率为92.5%（37/40），明显高于对照组的70.0%（28/40），差异有统计学意义（P<0.05）；观察组阴道不规则出血率（7.5%）明显低于对照组（37.5%），月经恢复正常率（92.5%）明显高于对照组（62.5%），差异有统计学意义（P<0.05）；观察组治疗后的白细胞介素-4、基质金属蛋白酶-9水平明显低于对照组，白细胞介素-10高于对照组，差异有统计学意义（P<0.05）。 结论 醋酸甲羟基孕酮联合抗生素相对于单独使用抗生素更有利于提高对子宫内膜炎的治疗效果、改善月经情况和减轻炎症反应，值得在临床上推广。

[关键词] 醋酸甲羟基孕酮；抗生素；子宫内膜炎；联合治疗

[中图分类号] R711.32 [文献标识码] A [文章编号] 1674-4721（2016）02（b）-0083-03

Clinical effect of medroxyprogesterone acetate combined with antibiotics treating endometritis

XU Xiao-lin1 YU Li-wei2

1.Department of Obstetrics and Gynecology，Shangrao Municipal Hospital in Jiangxi Province，Shangrao 334000，China；2.Department of Orthopedics，People′s Hospital of Kizilsu Kergez Prefecture in Xinjiang Uygur Autonomous Region，Kizilsu Kergez Prefecture 845350，China

[Abstract] Objective To explore the clinical effect of medroxyprogesterone acetate combined with antibiotics treating endometritis. Methods 80 patients with endometritis received by our hospital from June 2013 to December 2014 were randomly divided into control group （n=40） and observation group （n=40）.Patients in observation group were treated by medroxyprogesterone acetate combined with antibiotics.Patients in control group were treated by.Clinical effect，menstrual condition and the change of cytokine level before and after treatment between two groups was compared respectively. Results The total effective rate [92.5% （37/40）] in observation group was obviously higher than that [70.0% （28/40）] of control group，and the difference was statistical significance （P<0.05）.Irregular vaginal bleeding rate in observation group （7.5%） was obviously lower than that （37.5%） in control group；while the menstrual recover to normal rate （92.5%） was obviously higher than that （62.5%） in control group，and the difference was statistical significance （P<0.05）.After treatment，the level of IL-4 and MMP-9 in observation group was obviously lower than that of control group，while IL-10 was higher than that of control group，the difference was statistical significance （P<0.05）. Conclusion Compared with using antibiotics simply，medroxyprogesterone acetate combined with antibiotics is more helpful to improve the therapy effect for endometritis，improve menstrual condition and alleviate inflammatory reaction.It is worth to popularize in clinic.

[Key words] Medroxyprogesterone acetate；Antibiotics；Endometritis；Combined treatment

子宫内膜炎是妇科常见病、多发病之一，对女性的生殖健康和生活质量造成严重威胁。正常情况下，子宫腔具有良好的周期性内膜剥落或引流条件，使炎症发生机会大大减少[1]，但在急性炎症未给予及时治疗或存在持续感染源的情况下，炎症会反复发作，进而造成子宫内膜炎。目前临床上单纯运用中药治疗或西药治疗均未达到根除的效果[2]。本研究选取在我院接受治疗的80例子宫内膜炎患者，分别予以常规抗生素治疗和醋酸甲羟基孕酮联合抗生素治疗，比较分析疗效，现报道如下。

1 资料与方法

1.1 一般资料

选取2013年6月～2014年12月在我院妇科接受治疗的80例子宫内膜炎患者，均符合《中华妇产科学》[3]中子宫内膜炎的诊断标准。所选患者均有不同程度的白带增多、色黄、质稀、脓性或混有血，并且伴恶臭味；伴不同程度的下腹疼痛，呈放射性并向双侧大腿延伸，体温上升至39～40℃，妇科检查见宫体增大并伴压迫性疼痛，体质呈虚弱状态。……