GnRH-a联合BREA治疗围绝经期异常子宫出血的临床疗效

doi:10.3969/j.issn.1671-7171.2023.11.014

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摘要【目的】探讨促性腺激素释放激素激动剂(GnRH-a)联合双极射频子宫内膜去除术(BREA)治疗围绝经期异常子宫出血患者的疗效。【方法】选取2019年6月至2021年6月在本院诊治的86例围绝经期异常子宫出血患者,采用随机抽样法分为观察组和对照组,每组43例。对照组采用BREA治疗,观察组采用GnRH-a联合BREA治疗。比较两组有效率及治疗前后月经失血图(PBAC)评分、子宫体积、子宫内膜厚度、性激素[雌二醇(E₂)、黄体生成素(LH)、卵泡刺激素(FSH)、孕酮(P)]水平。【结果】治疗前,两组PBAC评分比较,差异无统计学意义(P>0.05);治疗后3个月、6个月、12个月,两组PBAC评分均呈下降趋势,且观察组PBAC评分均低于对照组(P<0.05)。治疗后3个月、6个月、12个月,观察组有效率均高于对照组(P<0.05)。治疗前,两组E₂、LH、FSH、P水平比较,差异无统计学意义(P>0.05);治疗后,两组E₂、LH、FSH、P水平均降低,且观察组低于对照组(P<0.05)。治疗前,两组子宫体积和子宫内膜厚度比较,差异无统计学意义(P>0.05);治疗后6个月、12个月,两组子宫体积和子宫内膜厚度均减小,且观察组均小于对照组(P<0.05)。【结论】围绝经期异常子宫出血患者BREA治疗前采用GnRH-a进行预处理,可提高临床疗效,改善血清性激素水平,降低PBAC评分,具有临床推广价值。

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	雷晓娟
	李红艳
	郭天宝

关键词 ：子宫出血/治疗, 围绝经期, 促性腺素释放激素/药理学, 子宫内膜消融技术

Abstract：【Objective】To investigate the efficacy of gonadotropin-releasing hormone agonist(GnRH-a) combined with bipolar radiofrequency endometrial ablation(BREA) in the treatment of patients with perimenopausal abnormal uterine bleeding. 【Methods】From June 2019 to June 2021,86 patients with perimenopausal abnormal uterine bleeding treated in our hospital were selected and randomly divided into the observation group and the control group,with 43 cases in each group. The control group was treated with BREA,while the observation group received GnRH-a combined with BREA treatment. The efficacy rate,as well as changes in the Pictorial Blood Assessment Chart(PBAC) score,uterine volume,endometrial thickness,and levels of sex hormones [estradiol(E₂),luteinizing hormone(LH),follicle-stimulating hormone(FSH),progesterone(P)] before and after treatment were compared between the two groups. 【Results】Before treatment,there was no significant difference in PBAC scores between the two groups(P>0.05). Three months,six months,and twelve months after treatment,PBAC scores of both groups showed a downward trend,and the PBAC scores of the observation group were consistently lower than those of the control group(P<0.05). The effective rate of the observation group was higher than that of the control group at three months,six months,and twelve months after treatment(P<0.05). Before treatment,there was no significant difference in the levels of E₂,LH,FSH,and P between the two groups(P>0.05). After treatment,the levels of E₂,LH,FSH,and P decreased in both groups,with the observation group showing lower levels than the control group(P<0.05). Before treatment,there was no significant difference in uterine volume and endometrial thickness between the two groups(P>0.05). Six months and twelve months after treatment,both uterine volume and endometrial thickness were reduced in both groups,with the observation group having smaller measurements than the control group(P<0.05). 【Conclusion】Pre-treatment with GnRH-a before BREA therapy in patients with perimenopausal abnormal uterine bleeding can improve clinical efficacy,adjust serum sex hormone levels,and reduce PBAC scores,and is of clinical value for widespread promotion.

Key words： Uterine Hemorrhage/TH Perimenopause Gonadotropin-Releasing Hormone/PD Endometrial Ablation Techniques

收稿日期: 2023-02-16

中图分类号:

R711.52

通讯作者: * E-mail:15029961373@163.com

引用本文:

雷晓娟, 李红艳, 郭天宝. GnRH-a联合BREA治疗围绝经期异常子宫出血的临床疗效[J]. 医学临床研究, 2023, 40(11): 1663-1666.
LEI Xiaojuan, LI Hongyan, GUO Tianbao. Clinical Efficacy of GnRH-a Combined with BREA in the Treatment of Perimenopausal Abnormal Uterine Bleeding. JOURNAL OF CLINICAL RESEARCH, 2023, 40(11): 1663-1666.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.11.014 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I11/1663

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