Comparison of the clinical effect of levonorgestrel intrauterine contraceptive system and medroxyprogesterone acetate respectively combined with transcervical resection of endometrium on perimenopausal abnormal uterine bleeding
Objective To compare the clinical effect of levonorgestrel intrauterine contraceptive system and medroxyprogesterone acetate respectively combined with transcervical resection of endometrium(TCRE)on perimenopausal abnormal uterine bleeding.Methods A total of 86 patients with perimenopausal abnormal uterine bleeding admitted in General Hospital of Medical Union,Shaoxing Central Hospital of Zhejiang Province from April 2019 to April 2023 were enrolled as research objects.According to the random number table method,they were divided into combined group(levonorgestrel intrauterine contraceptive system combined with TCRE)and progesterone group(medroxyprogesterone acetate combined with TCRE),with 43 cases in each group.The efficacy at the 3rd month of treatment and menstrual conditions(menstrual cycle,menstrual time),indicators of blood and sex hormones before surgery and at the 3rd month after surgery were compared between the two groups.The rebleeding rate and the conditions of adverse drug reactions within 3 months after surgery were counted.Results At the 3rd month of treatment,the efficacy in combined group was significantly higher than that in progesterone group,and the difference was statistically significant(P＜0.05).The menstrual cycles in the two groups at the 3rdmonth after surgery were significantly increased than those before surgery(P＜0.05),and the menstrual time was significantly shortened(P＜0.05).The menstrual cycle and menstrual time in the combined group were all significantly better than those in the progesterone group,with statistically significant differences(P＜0.05).The levels of hemoglobin(Hb),D-dimer and fibrinogen(FIB)in the two groups were all significantly increased at the 3 rd month after surgery(P＜0.05),and the levels in the combined group were significantly higher than those in the progesterone group with statistically significant difference(P＜0.05).At the 3rd month after surgery,the levels of estradiol(E2),follicle stimulating hormone(FSH)and luteinizing hormone(LH)were all significantly decreased in both groups(P＜0.05),and the combined group had significantly lower levels than those in the progesterone group with statistically significant difference(P＜0.05).The rebleeding rate within 3 months after surgery in the combined group was significantly lower than that in the progesterone group(P＜0.05).There was no significant difference in comparing the adverse reaction rates between the two groups(P＞0.05).Conclusions Compared with medroxyprogesterone acetate combined with TCRE,levonorgestrel intrauterine contraceptive system combined with TCRE can significantly improve the clinical efficacy in patients with perimenopausal abnormal uterine bleeding.It is more conducive to the recovery of menstruation,sex hormones and blood indicators,and has lower risk of postoperative rebleeding with good safety.
Levonorgestrel intrauterine contraceptive systemMedroxyprogesterone acetateAbnormal uterine bleedingTranscervical resection of endometrium
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