CAJ | 학술논문

目的探讨慢性肾功能不全患者月经过多的临床治疗。方法本次研究选择的对象共40例，均为我院2008年2月～2012年2月收治的慢性肾功能不全患者，均采用左炔诺孕酮宫内缓释系统治疗，回顾临床资料。结果本组40例患者中，置入左炔诺孕酮宫内缓释系统3个月后月经量明显减少，12个月后点滴出血或少量出血，闭经2例。治疗前PBAC评分（135.7±40.6）分，治疗6个月后为（32.8±8.7）分，差异有统计学意义（P＜0.05）。治疗3个月后月经期平均为（16.3±7.4）d，置入6个月后平均为（8.4±5.3）d，差异有统计学意义（P＜0.05）。与治疗前比较，血红蛋白明显增高，子宫内膜厚度明显减轻，差异均有统计学意义（P＜0.05），血清孕酮平均浓度差异无统计学意义（P＞0.05）。结论慢性肾功能不全患者月经过多采用左炔诺孕酮宫内缓释系统治疗，可使月经量明显减少，增高血红蛋白水平，减轻子宫内膜厚度，改善临床体征及症状，且无明显不良反应，使患者预后获得理想改善，具有非常积极的临床意义，值得在临床广泛开展应用。
목적탐토만성신공능불전환자월경과다적림상치료。방법본차연구선택적대상공40례，균위아원2008년2월～2012년2월수치적만성신공능불전환자，균채용좌결낙잉동궁내완석계통치료，회고림상자료。결과본조40례환자중，치입좌결낙잉동궁내완석계통3개월후월경량명현감소，12개월후점적출혈혹소량출혈，폐경2례。치료전PBAC평분（135.7±40.6）분，치료6개월후위（32.8±8.7）분，차이유통계학의의（P＜0.05）。치료3개월후월경기평균위（16.3±7.4）d，치입6개월후평균위（8.4±5.3）d，차이유통계학의의（P＜0.05）。여치료전비교，혈홍단백명현증고，자궁내막후도명현감경，차이균유통계학의의（P＜0.05），혈청잉동평균농도차이무통계학의의（P＞0.05）。결론만성신공능불전환자월경과다채용좌결낙잉동궁내완석계통치료，가사월경량명현감소，증고혈홍단백수평，감경자궁내막후도，개선림상체정급증상，차무명현불량반응，사환자예후획득이상개선，구유비상적겁적림상의의，치득재림상엄범개전응용。
Objective To investigate the clinical treatment of menorrhagia in patients with chronic renal insufficiency. Methods The clinical data of 40 cases with chronic renal insufficiency treated with levonorgestrel releasing intrauterine system in our hospital from February 2008 to February 2012 were analyzed retrospectively. Results The menstrual blood volume reduced significantly after three months of the placement treatment of levonorgestrel releasing intrauterine system in 40 patients, and spotting or minimal menstrual hemorrhage were happened after 12 months, 2 cases happened amenorrhea. The PBAC score before the treatment was (135.7±40.6) score, while the PBAC score after 6 months of the treatment was (32.8±8.7)score, and the difference was statistically significant(P < 0.05). The average menstrual period after 3 months of the treatment was (16.3±7.4)days, while the average menstrual period after 6 months of the treatment was (8.4±5.3) days, and the difference was statistically significant(P < 0.05). Compared with before the treatment, the level of hemoglobin increased significantly, the thickness of endometrium reduced significantly,and the differences were statistically significant(P<0.05); while the difference of average concentration of serum progesterone were not statistically significant(P > 0.05). Conclusion Levonorgestrel releasing intrauterine system treatment for menorrhagia in patients with chronic renal insufficiency can reduce the menstrual blood volume significantly, increase the level of hemoglobin, reduce the thickness of endometrium, improve clinical signs and symptoms, and no significant adverse reaction happen, improve the prognosis of patients significantly. It has very positive clinical significance, and is worthy of clinical application widely.