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人工流产术后注射复方庚酸炔诺酮对痛经程度及月经模式的影响研究
万婷, 秦爽, 岳超敏, 谢永梅, 张晓霞, 黄见明, 李扬志, 李智敏, 雷秀雯, 熊小琴, 刘玉娴, 李丽琴, 罗小婉, 董徐男, 杜雪莲, 金平, 王晓蓉, 李维茹, 李莉
中国实用妇科与产科杂志 ›› 2025, Vol. 41 ›› Issue (5) : 569-572.
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PDF(903 KB)
人工流产术后注射复方庚酸炔诺酮对痛经程度及月经模式的影响研究
Study on the effect of injection of compound norethisterone enanthate after induced abortion on the severity of dysmenorrhea and menstrual pattern
目的 对孕早期终止妊娠合并原发性痛经患者在人工流产术后注射复方庚酸炔诺酮，探讨其对痛经程度及月经模式的影响。方法 对2021年 12月 至2022年 10月来自广东省13家公立三甲医院计划生育门诊就诊要求终止妊娠且有原发性痛经病史的308例早期妊娠患者，在人工流产术后注射复方庚酸炔诺酮，比较其注射前后月经模式及痛经评分的变化。结果 人工流产术后连续注射复方庚酸炔诺酮3个月，痛经程度逐渐减轻，注射前及注射后第1、2、3个月痛经视觉模拟评分法（VAS）评分分别为（4.90±1.82）、（2.97±1.80）、（1.58±1.57）和（0.86±1.20）分，前后比较差异有统计学意义（P<0.001）。人工流产术前，经期平均（3.26±1.05）d；注射后第1个月，经期平均（5.57±2.18）d；注射后第2个月，经期平均（5.56±1.72）d；注射后第3个月，经期平均（5.08±1.72）d，注射后与注射前比较，差异有统计学意义（P<0.05）。注射前后肝肾功能及凝血功能指标比较，无明显差异（P>0.05）。结论 人工流产术后即时注射复方庚酸炔诺酮治疗痛经疗效显著；对月经模式的影响主要表现为经期点滴出血时间延长，随着注射周期增加，经期逐渐缩短，且对月经周期及月经总量无明显影响。患者肝肾及凝血功能指标注射前后无明显变化。
Objective For patients with primary dysmenorrhea who undergo termination of pregnancy in the early stages of pregnancy，inject compound norethisterone enanthate after induced abortion procedure；discuss its effect on menstrual patterns and the severity of dysmenorrhea. Methods From December 2021 to October 2022，a total of 308 early pregnancy patients from 13 public tertiary A hospitals in Guangdong Province who requested termination of pregnancy and had a history of primary dysmenorrhea were treated with injection of compound norethisterone enanthate after induced abortion，and compared the changes in menstrual patterns and dysmenorrhea scores were compared before and after the injection. Result After continuous injection of compound norethisterone enanthate for 3 months following an abortion，the severity of dysmenorrhea gradually decreased. The VAS score for dysmenorrhea before injection was （4.90±1.82），and the scores for the first，second，and third months after injection were （2.97±1.80），（1.58±1.57），and （0.86±1.20） respectively. There was a statistically significant difference before and after treatment （P<0.001）.The average menstruation duration before aboration was （3.26±1.05） days，the average duration of the first menstrual period after injection was （5.57±2.18） days，the average duration of the second menstrual period was （5.56±1.72） days，and the average duration of the third menstrual period was （5.08±1.72） days. Compared with the average duration before injection，there was a statistically significant difference （P<0.05）. Conclusions Immediate injection of compound norethisterone enanthate after abortion has significantly efficacy in the treatment of dysmenorrhea；the impact on menstrual patterns mainly manifests as prolonged spotting during menstruation. With an increase in the cycles of injections，the duration of menstruation gradually shortens，and there is no significant effect on menstrual cycle or total menstrual flow. There are no significant changes in liver and kidney function or coagulation function-related indicators compared to before injection.
复方庚酸炔诺酮 / 人工流产 / 原发性痛经 / 月经模式 / 凝血功能 / 肝肾功能
compound norethisterone enanthate / induced abortion / primary dysmenorrhea / menstrual patterns / coagulation function / liver and kidney function
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This is a retrospective study of 1,042 new acceptors of injectable progestogen-only contraceptives at the family planning clinic of the University of Ilorin Teaching Hospital over a five year period from 1st January 2001 to 31st December 2004. The total number of new clients seen during this period was 4,752. 41.1% of these new clients chose condoms as a contraceptive method, 32.2% accepted IUCD, 21.9% accepted injectable progestogen-only contraceptive 08% accepted implants, 3.9% combined oral contraceptive pills and 0.1% bilateral tubal ligation. Of the acceptors of injectable progestogen, 59.5% used depo medroxyprogesterone acetate while 40.5% used norethisterone enanthate. 59.5% of the acceptors belonged to the 30 - 39 years age bracket and 36.2% were grandmultiparous women Injectable progestogen-only contraceptives are among the safest and most effective contraceptive methods available. The two commonly available types are Depot Medroxyprogesterone acetate and Norethisterone enanthate. This study looked at the clinical experience with this form of contraceptive at University of Ilorin Teaching Hospital (UITH).The case notes of new clients that accepted injectable progestogen-only contraceptive at the family planning clinic of the UITH between June 2001 and December 2004 were analysed.Injectable progestogen-only contraceptive was the third most commonly accepted method of contraception at UITH during the study period. 59.5% of clients belonged to the 30-39 year age group, 63.5% of them were para 1-4 and 36.2% were grandmultiparous women. 59.8% of the clients were educated up to the secondary level or above. There was no pregnancy reported during the study period. 29.9% of clients experienced various forms of side effects, the commonest of which was menstrual irregularities.Injectable progestogen-only contraceptive is widely accepted by women in this centre. Its use cuts across women of all age groups, parities, religion and level of education.
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Progesterone is a steroid hormone traditionally linked with female fertility and pregnancy. In current reproductive medicine, progesterone and its analogues play crucial roles. While the discovery of its effects has a long history, over recent decades, various novel actions of this interesting steroid have been documented, of which its neuro- and immunoprotective activities are the most widely discussed. Discoveries of the novel biological activities of progesterone have also driven research and development in the field of progesterone analogues used in human medicine. Progestogen treatment has traditionally and predominately been used in maintaining pregnancy, the prevention of preterm labor, various gynecological pathologies, and in lowering the negative effects of menopause. However, there are also various other medical fields where progesterone and its analogues could find application in the future. The aim of this work is to show the mechanisms of action of progesterone and its metabolites, the physiological and pharmacological actions of progesterone and its synthetic analogues in human medicine, as well as the impacts of its production and use on the environment.
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Observational data suggest lower HIV risk with norethisterone enanthate (NET-EN) than with depo-medroxyprogesterone acetate intramuscular (DMPA-IM) injectable contraceptives. If confirmed, a switch between these similar injectable methods would be programmatically feasible and could impact the trajectory of the HIV epidemic. We aimed in this paper to investigate the effects of DMPA-IM and NET-EN on estradiol levels, measures of depression and sexual activity and menstrual effects, relevant to HIV risk; and to ascertain whether these measures are associated with estradiol levels.
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