左炔诺孕酮宫内缓释系统治疗子宫腺肌病临床效果研究

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)治疗子宫腺肌病的临床疗效。方法:102例子宫腺肌病患者在月经周期第7天放置LNG-IUS,观察放置前,放置后1、3、6、12个月的月经情况,痛经程度及副反应。结果:①放置LNG-IUS后随访102例,其中8例取LNG-IUS终止治疗(5例因月经过少,3例因痤疮),12个月续用率为92.16%(94/102)。②放置后1、3、6、12个月,随时间延长,视觉模拟评分(VAS)和口述评分(VRS)痛经评分逐渐下降,与放置前比较,差异均有统计学意义(P<0.05)。③放置LNG-IUS后出血模式主要表现为月经过少,放置后1个月,68.63%(70/102)患者月经过少;放置后3个月,78.43%(80/102)患者月经过少;放置后12个月,91.49%(86/94)患者月经过少。④主要副反应为不规则出血,放置后1个月不规则出血发生率18.63%(19/102),放置后3个月不规则出血发生率11.76%(12/102),6个月以后无不规则出血。随访12个月闭经发生率6.38%(6/94)。结论:LNG-IUS治疗子宫腺肌病近期疗效显著,不良反应少,临床应用价值高。

Objective： To evaluate the clinical effect of levonorgestrel-releasing intrauterine system （LNG-IUS） in the treatment of adenomyosis. Methods：One hundred-two patients with adenomyosis were treated with LNG-IUS, and the menstrual patterns, severity of dysmenorrhea and side effects were observed at baseline and 1, 3, 6, 12 months after treating with LNG-IUS. Results：①102 cases were followed after device insertion, 8 cases requested removal of the device（ 5 for oligomenorrhea, and 3 for acne）. At 12 months, the overall continuation rate was 92. 16% （94/102）; @）The VAS and VRS of dysmenorrhea dropped continuously and significantly after the LNG-IUS insertion （P 〈 0. 05） ; ②Oligomenorrhea occurred in 68.63%, 78.43% and 91.49% patients at 1, 3, 12 months after insertion, respectively. lrregular bleeding was the main side effect, which occurred in 19 women 1 month after insertion and in 12 women 3 months after insertion. After 6 months of observation, irregular bleeding was not present in any patient. In addition, 6 women reported amenorrhea in 12 months after insertion. Conclusions：LNG-IUS is an effective method for controlling the symptoms of adenomyosis in one year＇s observation.