左炔诺孕酮宫内缓释系统治疗子宫腺肌病的临床观察

Effect of levonorgestrel-releasing intrauterine system in the treatment of adenomyosis

目的探讨左炔诺孕酮宫内缓释系统(LNG-IUS;商品名:曼月乐)治疗子宫腺肌病的临床疗效。方法对42例根据临床症状、彩色超声或MRI检查、腹腔镜或开腹手术诊断为子宫腺肌病的患者,宫内放置LNG-IUS,观察月经量、痛经程度及子宫体积变化。结果放置LNG-IUS后3个月,月经量显著减少,治疗3个月时的月经量降低为治疗前的(27±11)%,治疗前后比较,差异有统计学意义(P<0.01);治疗前子宫体积为(143±33)cm3,治疗3个月时子宫体积为(115±22)cm3,治疗前后比较,差异也有统计学意义(P<0.05);42例患者痛经症状显著缓解或完全消失;20例贫血患者血红蛋白水平从治疗前的(86±14)g/L恢复至治疗后的(124±8)g/L。结论LNG-IUS治疗子宫腺肌病近期疗效显著。

Objective To assess the clinical efficacy of levonorgestrel-releasing intrauterine system （LNG-IUS） an the treatment of adenomyosis. Methods Forty-two patients with adenomyosis diagnosed by clinical symptoms, MRI, laparoscopy and/or chromatic colour type-B ultrasound were treated with LNG-IUS, and the menstrual blood volume, severity of dysmenorrhea and uterine volume were observed three months later. Results After 3 month treatment of LNG-IUS, the menstrual blood volume reduced significantly to （ 27 ± 11 ） % of that before treatment. The uterine volume was decreased from （ 143 ± 33 ） cm^3 to （ 115 ± 22 ） cm^3 （ P 〈 0. 05 ） . Dysmenorrhea was completely relieved or significantly alleviated. Hemoglobin recovered to （ 124 ＋8）g/L（P 〈0. 05）in 20 patients with anemia. Conclusion LNG-IUS is an effective and safe method in the short-term treatment of adenomyosis.