固定式LNG宫内缓释剂用于子宫腺肌症患者避孕的临床观察

Clinical observation on the contraceptive efficacy of the fixed levonorgestrel-releasing intrauterine system for the patients with adenomyosis

目的:观察固定式左炔诺孕酮(LNG)宫内缓释剂用于子宫腺肌症患者避孕的临床效果。方法:将100例确诊为子宫腺肌症的妇女随机分为两组,观察组(50例)放置固定式LNG宫内缓释剂,对照组(50例)放置左炔诺孕酮宫内缓释系统(LNG-IUS),观察放置12个月的带器妊娠、下移、脱落、副作用情况及避孕外益处等。结果:两组随访期内均无带器妊娠,观察组下移或脱落率(0%)较对照组(10%)低(P<0.05);两组均无明显副作用。两组放置前后自身痛经程度比较差异有统计学意义(P<0.05),两组放置后均较放置前经量减少(P<0.05),血红蛋白水平升高(P<0.05)。结论:固定式LNG宫内缓释剂用于子宫腺肌症患者避孕,不易下移、脱落,效果优于LNG-IUS。

Objective： To investigate the clinical efficacy of the fixed levonorgestrel -releasing intrauterine system for the patients with adenomyosis. Methods： A total of 100 patients with adenomyosis were divided into two groups, and inserted with the fixed levonorgestrel - releasing intrauterine system （ fixed LNG - IUS group, n = 50） and LNG - IUS （ control group, n = 50）, respectively. The pregnancy with IUD in situ, the IUD expulsion rate, the side effects and the non - contraceptive bene- fits were observed after 3,6,12 months of insertion. Results： In the two groups, no patients experienced a pregnancy with IUD in situ, The expulsion rate of the fixed LNG - IUS group （0%） was significantly lower than that of the control group （ 10% ） （P 〈 0. 05 ）. No obvious side effects were found in either group. The VRS scores of algomenorrhea in the fixed LNG - IUS group and control group were 2.45 ± 0.64, 2.53 ± 0. 67 before the insertion, respectively, and significantly dropped to 1.53 ± 0.61, 1 . 49 ± 0. 58 （3 months after insertion）, 1.32 ± 0. 65, 1. 20 ± 0. 63 （6 months after insertion） and 0.81 ± 0.62, 0.82 ±0.61 （ 12 months after insertion）, respectively （P 〈0.05）. There was no significant difference in the VRS scores between the two groups at any corresponding time - points （P 〉 0.05）. The scores of pictorial blood assessment chart （PBAC） were significantly lower and the serum hemoglobin levels significantly higher after the insertion of either IUD （ P 〈 0.05 ）. Conclusion： The fixed LNG - IUS is a more effective treatment than LNG - IUS for the patients with adenomyosis.