应用带铜节育器治疗继发性功能性闭经的35例临床观察

Application of copper IUD with functional treatment of secondary amenorrhea of 35 cases of clinical observation

目的探讨应用带铜节育器（IUD）治疗继发性功能性闭经的疗效。方法 2002年3月—2009年10月在本院门诊就诊的35例自愿参加治疗的继发性功能性闭经患者,闭经时间为4个月-3年,无过度肥胖和极度消瘦者,B超及盆腔检查子宫、卵巢无异常,血清促卵泡素（FSH）、黄体生成素（LH）、孕酮（P）、睾酮（T）、催乳素（PRL）及17β-雌激素（E2）值正常而黄体期孕酮水平低于正常者,宫内放置带铜节育器。结果 35例中29例患者放置IUD数周后月经恢复,总有效率的83%,而6例患者因放置带铜IUD3个月后月经未恢复后转内分泌治疗。29例中18例患者因月经正常而选择带铜IUD避孕至今,4例患者放置IUD月经正常1-2年后取出带铜IUD,其正常月经维持7个月-1年,后出现月经量减少,7例患者月经正常2-3年后取出IUD,其正常月经仍维持2-3年,7例中2例患者妊娠分娩已1年多,现月经基本正常,5例又出现月经量减少。结论宫内放置带铜IUD治疗继发性闭经可以使其恢复规律的月经。

Objective To investigate the application of IUD with copper treatment of secondary amenorrhea of functional results.Methods Out-patient treatment of 35 cases of voluntary participation in the treatment of secondary amenorrhea in patients with sexual function from March 2002 to 2008 October,amenorrhea time-4months to 3 years,non-obese and extremely thin person,B-and pelvic examination the uterus,ovary without abnormal serum FSH,LH,P,T,PRL,and 17β-E2 and the value of the normal luteal phase progesterone levels were lower than normal,intrauterine copper IUD placed with.Results 29 cases of patients with IUD placed after the resumption of menstrual weeks,of which 18 cases of patients with menstrual normal and copper IUD contraceptive choices so far,four cases of patients with normal menstrual place 1 year after the IUD removed with copper IUD,the maintenance of the normal menstrual seven month decreased menstruation,7 months to 1 year cases of patients with normal menstrual removed 2 to 3years after the IUD,remained normal 1 year period,during which the two cases of pregnancy until childbirth,menstruation occurred in five cases of a decline in six cases of patients with available copper IUD 3 months period did not resume after the switch to endocrine therapy.Conclusion Intrauterine copper IUD placed with the treatment of secondary amenorrhea can restore menstrual regularity.