Departments of Obstetrics and Gynecology, SUNY Downstate Medical Center.
Int J Womens Health. 2010 Sep 1;2:297-302. doi: 10.2147/IJWH.S11531.
To manage patients with dysfunctional uterine bleeding (DUB) according to endometrial thickness.
A retrospective chart review of 49 patients who reported 8 or more days of bleeding was performed. They were then divided into three groups based on endometrial thickness (mm): less than 6, 6-11, and greater than 11. These three groups were treated with combined oral contraceptive pills (OCP), conjugated estrogen plus progesterone and megestrol respectively. Patients given megestrol also underwent endometrial biopsy before treatment. Patients recorded the degree of bleeding each day for one month after starting treatment.
Mean endometrial thickness in the combined OCPs, conjugated estrogen plus progesterone and megestrol groups were 4, 8 and 14 mm, respectively. Combined OCPs decreased bleeding from 46 to 8 days (P < 0.05, n = 8). Conjugated estrogen plus progesterone decreased the number of days of bleeding from a mean of 41 to 9 (P < 0.01, n = 16). Megestrol decreased bleeding from 54 to 3 days (P < 0.001, n = 25). 52% of patients given megestrol had endometrial hyperplasia.
These results support the effectiveness of treating patients with DUB according to endometrial thickness.
根据子宫内膜厚度管理子宫功能失调性出血（DUB）患者。
对 49 例报告出血 8 天以上的患者进行回顾性图表分析。然后根据子宫内膜厚度（mm）将他们分为三组：小于 6mm、6-11mm 和大于 11mm。这三组分别用复方口服避孕药（OCP）、结合雌激素加孕激素和甲地孕酮治疗。给予甲地孕酮的患者在治疗前还进行了子宫内膜活检。患者在开始治疗后一个月内每天记录出血程度。
联合 OCP、结合雌激素加孕激素和甲地孕酮组的平均子宫内膜厚度分别为 4、8 和 14mm。联合 OCP 将出血天数从 46 天减少至 8 天（P<0.05，n=8）。结合雌激素加孕激素将出血天数从平均 41 天减少至 9 天（P<0.01，n=16）。甲地孕酮将出血天数从 54 天减少至 3 天（P<0.001，n=25）。52%给予甲地孕酮的患者存在子宫内膜增生。
这些结果支持根据子宫内膜厚度治疗 DUB 患者的有效性。
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