Comparison Of The Clinical Effects Of Mirena And Transcervical Resection Of Endometrium (TCRE) In The Treatment Of Perimenopausal Abnormal Uterine Bleeding

ObjectiveTo explore the Mirena and TCRE in the menopausal transition a curative effect in the treatment of abnormal uterine bleeding and application value.MethodsRetrospective analysis of 128 patients with perimenopausal abnormal uterine bleeding, 62 cases accepted the Mirena for the Mirena group, 66 patients who underwent TCRE treatment for TCRE group. The Mirena place intrauterine in menstrual 5 to 7 days, Then the regular follow-up observations; TCRE group 2 ~ 5days after menstruation is clean by under hysteroscopic cervical endometrial resection,postoperative follow-up on a regular basis. Records both follow-up treatment 1, 3, 6and 12 months after menstruation PBLAC score, endometrial thickness, ultrasound test detection routine blood hemoglobin, grade gynecologic endocrine, etc.Results1. The menstrual flow decreased in the Mirena group after treatment, the difference was statistically significant(P <0.05). TCRE Postoperative patients with amenorrhea. The TCRE group patients after treatment of artificial amenorrhea,menstrual volume score decreased significantly.There were significant differences in TCRE and Mirena menstruation scores between the first month, the third month, the sixth month and the twelfth month(P <0.05)?The menstrual flow in the TCRE group was significantly lower than that in the Mirena group.2. The Mirena group and TCRE group treated perimenopausal abnormal uterine bleeding were effective, the effective rate of the two groups was not statistically significant(P> 0.05).3.In Mirena group, the thickness of the endometrium was 10.20±2.11 mm after placement for 1 month and 7.25±2.12 mm for 3 months, 6.71 ± 1.51 mm for 6 months and 5.92±1.63 mm for 12 months, respectively, and the thickness before placement was 12.85 ± 5.13 mm, the difference was statistically significant(P <0.05). After the placement of Mirena, the endometrium of patients gradually thinning, the difference was statistically significant(P <0.05). The endometrial thickness of the TCRE group was significantly lower at 1 month, 3 months, 6 months and 12 months after operation than that before operation(P <0.05), and the thickness of endometrium was significantly thinner4. The hemoglobin content in Mirena group and TCRE group were all increased after treatment, and the difference was statistically significant(P <0.05), anemia was corrected.5. There was no significant difference in the gynecologic endocrine hormone levels between the Mirena group and TCRE group before and after treatment(P>0.05).6. The incidence of adverse reactions in the Mirena group was 19.35%,The incidence of adverse reactions in TCRE group was 9.09%,The incidence of adverse events in the TCRE group was lower than that in the Mirena group.Conclusion1. The Mirena and TCRE in clinical treatment of abnormal uterine bleeding in perimenopausal are safe and effective. To avoid repeated pain medication and curettage, and uterus without affecting the ovarian endocrine functions.2. The Mirena group of patients, month menstrual quantity reduce gradually, his clinical symptoms gradually improved and anemia obvious improvement; TCRE patients most women amenorrhea and artificial amenorrhoea, clinical symptoms improved significantly, anemia, improve.3. Ultrasound monitoring endometrial thickness, the Mirena in endometrial thinning of the set of endometrial finishes the change TCRE group was obviously,surgical scar permanent form.4. Women use the Mirena symptom recovery is a gradual process, and once the rings fall off, shift, symptoms easily repeatedly; TCRE treat symptoms recover quickly, is not easy to relapse, and the Mirena treatment failure of effective treatments.