目的 觀察醋酸甲羥孕酮聯(lián)合克林霉素磷酸酯治療產(chǎn)后子宮內(nèi)膜炎的臨床療效。方法 選取2013年1月—2015年1月黃石市中心醫(yī)院收治的產(chǎn)后子宮內(nèi)膜炎患者150例,隨機(jī)分為對(duì)照組和治療組,每組各75例。對(duì)照組患者口服克林霉素磷酸酯片,2片/次,3次/d;治療組在對(duì)照組治療的基礎(chǔ)上口服醋酸甲羥孕酮片,3片/次,3次/d。兩組均連續(xù)治療14 d。觀察兩組的臨床療效,同時(shí)比較兩組患者腹痛感消失時(shí)間、炎癥消失時(shí)間、白細(xì)胞恢復(fù)正常時(shí)間、體溫恢復(fù)正常時(shí)間,比較兩組血清腫瘤壞死因子(TNF-α)、C反應(yīng)蛋白的變化。結(jié)果 治療后,對(duì)照組和治療組總有效率分別為77.33%、92.00%,兩組總有效率比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。治療組患者腹痛感消失時(shí)間、炎癥消失時(shí)間、白細(xì)胞恢復(fù)正常時(shí)間、住院時(shí)間和體溫恢復(fù)正常時(shí)間均顯著短于對(duì)照組患者,兩組比較差異均有統(tǒng)計(jì)學(xué)意義(P < 0.05)。兩組患者治療后血清TNF-α和C反應(yīng)蛋白水平較治療前顯著降低,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P < 0.05);且治療后治療組的改善程度優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P < 0.05)。結(jié)論 醋酸甲羥孕酮聯(lián)合克林霉素磷酸酯治療產(chǎn)后子宮內(nèi)膜炎具有較好的臨床療效,可縮短臨床癥狀改善時(shí)間,還可降低TNF-α、C反應(yīng)蛋白水平,值得推廣應(yīng)用。

Objective To observe the clinical curative effect of medroxyprogesterone acetate combined with clindamycin phosphate in treatment of postpartum endometritis. Methods Patients (150 cases) with postpartum endometritis of Huangshi Central Hospital from January 2013 to January 2015, were randomly divided into control and treatment groups, and each group had 75 cases. The patients in control group were po administered with Clindamycin Phosphate Tablets, 2 tablets/time, three times daily. The patients in the treatment group were po administered with Medroxyprogesterone Acetate Tablets on the basis of the control group, 3 tablets/time, three times daily. Both groups were treated for 14 d. The clinical efficacies between two groups were observed after treatment. At the same time, extinction time of abdominal pain and inflammation, white blood cells recovery time, and body temperature recovery time in two groups were compared, while the changes of TNF-α and CRP in two groups were compared. Results The efficacies in the control and treatment groups were 77.33% and 92.00%, respectively, and there were differences between two groups (P < 0.05). After treatment, the disappear time of abdominal pain and inflammation, and back to normal time of white blood cells and body temperature in the treatment group were shorter than those in the control group, and there were differences between two groups (P < 0.05). After treatment, TNF-α and CRP in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant difference between two groups (P < 0.05). Results Medroxyprogesterone acetate combined with clindamycin phosphate has the good clinical effect in treatment of postpartum endometritis, and can shorten the improvement time of clinical symptoms, and reduce the level of TNF-α and CRP, which is worth clinical promotion.