左炔诺孕酮宫内缓释系统治疗子宫腺肌病的疗效

Clinical efficacy of levonorgestrel-releasing intrauterine system in treatment of adenomyosis

目的:探讨左炔诺孕酮宫内缓释系统(LNG-IUS;曼月乐)治疗子宫腺肌病的临床应用价值。方法:对36例子宫腺肌病的患者,宫内放置LNG-IUS,观察放置前后患者月经情况、痛经程度、子宫体积变化、血清CA125及不良反应。结果:放置LNG-IUS后,患者月经量显著减少,第1个月经量为原来的(35±11)%(P<0.01),12个月后为(6±2)%(P<0.01),26例贫血患者于放置3个月后血红蛋白恢复正常;放置1个月后患者痛经程度明显减轻,痛经评分由放置前的(2.3±0.37)分降为(1.2±0.14)分(P<0.01),放置6个月后,患者的痛经症状均消失;放置LNG-IUS前子宫体积为(232.43±71.14)cm3,放置6个月后子宫体积缩小(187.74±54.07)cm3(P<0.01);血清CA125于放置3个月后明显降低(P<0.01),且降至正常范围;患者无明显不良反应。结论:左炔诺孕酮宫内缓释系统治疗子宫腺肌病疗效显著,安全性好,为一种较好的保守治疗手段。

Objective：To explore the clinical application value of levonorgestrel-releasing intrauterine system（LNG-IUS） in treatment of adenomyosis.Methods：LNG-IUS was placed in 36 patients with adenomyosis,the menstruation,grades of dysmenorrhea,volume of uterus,serum CA125 level and adverse reactions before and after placement of LNG-IUS were observed.Results：After placement of LNG-IUS,the menstrual volume reduced significantly by（35±11）% on the first month and（6±2）% on the twelfth month（P0.01）.The hemoglobin level of 26 cases with anemia returned to normal on the third month after placement of LNG-IUS;the degree of dysmenorrhea relieved significantly on the first month after placement of LNG-IUS,the score of dysmenorrhea reduced from（2.3±0.37） to（1.2±0.14）（P0.01）;the symptom of dysmenorrhea of all the patients disappeared on the sixth month after placement of LNG-IUS.There was significant difference in volume of uterus before placement of LNG-IUS（（232.43±71.14） cm3） and 6 months later after placement of LNG-IUS（（187.74±54.07） cm3）（P0.01）;the serum CA125 level returned to normal on the third month after placement of LNG-IUS（P0.01）.No adverse reactions occurred.Conclusion：LNG-IUS is an effective and safe method in treatment of adenomyosis.