| Objective:To study the effect of hysteroscope combined with diprogesterone and mentholecular therapy on abnormal uterine bleeding during menstrual period.Methods:Our hospital outpatient service of department of gynaecology in January 2015-December 2015 outpatient service 92 patients with abnormal uterine bleeding in perimenopausal as the research object,all patients were diagnosed by hysteroscopy under direct or diagnostic curettage after pathologic diagnosis.By using digital table randomly divided into two groups,the flexor hysteroscopy combined with progesterone oral treatment of flexor progesterone group,46 patients hysteroscopy combined mann month LeHuan 46 cases of patients treated for month LeHuan group,two groups of patients before treatment with an average age,average fertility number,average weight,PBAC score,average haemoglobin,average thickness of endometrium,FSH,LH,PRL,E2,P,T level differences had no statistical significance(P>0.05),comparable.After treatment,all patients were followed up for 1,3,6 and 12 months,and the endometrial thickness was measured by ultrasound.Same type sanitary napkin patients using the same brand,each menstrual cramps detailed record last days,the quantity and the sanitary napkin with or without the degree of blood,blood clots with menstrual blood loss figure(PBAC)assessment before treatment,treatment 1,3,6,12 months of blood drawing;The visual analogizing score(VAS)was used to evaluate the pain degree and to record the adverse reactions during the treatment.Results:1)change in quantity:comparison in the group:the PBAC score of each group was significantly lower than before treatment in 1,3,6,and 12 months,and the difference was statistically significant(P<0.05).There was no statistically significant difference in PBAC scores between the groups(P>0.05)).The PBAC score of group b was significantly higher than that of group a,c and d,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the PBAC score between group a,c and d(P>0.05).In group a,PBAC score was higher than b,c and d in 6 months and 12 months,and the difference was statistically significant(P<0.05).There was no statistically significant difference in PBAC score between group b,c and d in 6 months and 12months(P>0.05).2)comparison of dysmenorrhea and relapse:comparison of the two groups:1,3,6,and 12 months after the treatment was significantly lower than before treatment,the difference was statistically significant(P<0.05).There was no statistically significant difference in VAS scores between the groups before treatment(P>0.05).There was no statistically significant difference between the treatment of 1,3,6,and 12 months with VAS score(P>0.05).The recurrence rate of group a was 4.35%in 6 months,and 0.00%in group b,c and d,with no statistically significant difference(P>0.05).The recurrence rate of group a was 10.87%in 12months,significantly higher than 0.00%in group b,c and d,and the difference was statistically significant(P<0.05).3)efficacy:the total effective rate in group a was100%,95.65%and 89.13%,respectively.Group b,c and d group were treated with100%,100%and 100%efficiency for 3,6 and 12 months.Group b,c and d were better than group a after 12 months of treatment,and the difference was statistically significant(P<0.05).4)endometrial thickness:ultrasonography was performed at 3,6 and 12 months after treatment before and after treatment,and the endometrial condition was observed and thickness was measured.Before treatment,ultrasound showed that the endometrium was continuous and the echo was even.Postoperative uterine endometrial continuity is poor,echo is not uniform,is linear or unclear,the thickness is significantly thinner than before surgery,suggesting that the endometrium is damaged after surgery.Comparison in the group:the endometrial thickness of each group was significantly lower than before treatment in 3,6 and 12months,and the difference was statistically significant(P<0.05).There was no statistically significant difference between groups in the treatment of endometrial thickness(P>0.05).There was no statistically significant difference in endometrial thickness in 3 months,6 months and 12 months(P>0.05).5)adverse reactions:4cases in group b,c and d had vaginal intravenous bleeding,which was understood after detailed explanation of the causes of bleeding.The incidence of adverse reactions was 17.39%;1 case of group a mild abdominal pain,did not make processing,had no impact on treatment,the incidence of adverse reactions was4.35%,the incidence of adverse reactions to b,c,d group was higher than group a,the difference was statistically significant(χ~2=5.019,P<0.05).Conclusion:1.Hysteroscopy combined with diprogesterone and menthol ring can effectively treat the abnormal uterine bleeding during menstruation.2.The hysteroscopy combined with manyule ring in the prevention of abnormal uterine bleeding recurrence rate,reduced the amount of blood volume of the effect of the progesterone.3.Vaginal intravenous hemorrhage is the most common adverse reaction in the placement of manyule ring,with a high incidence.The adverse reaction of diprogesterone is relatively small.the application can be used according to the situation. |
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