左炔诺酮宫内缓释系统联合米非司酮治疗子宫腺肌病的近远期疗效分析

Study on Effect of Levonorgestrel-Releasing Intrauterine System with Mifepristone for Uterine Adenomyosis

目的:探讨左炔诺酮宫内缓释系统(LNG-IUS)联合米非司酮治疗子宫腺肌病的近远期疗效及安全性。方法:将94例子宫腺肌病患者随机分为观察组(47例)和对照组(47例),观察组放置LNG-IUS,同时服用米非司酮,每月1次,疗程为6个月。对照组仅放置LNG-IUS。观察两组疗程结束后、放置LNG-IUS后1、3、5年的临床疗效及不良反应。结果:疗程结束后,观察组和对照组总有效率分别为91.5%,87.2%,差异无统计学意义(P>0.05);随访期间,观察组的月经期、月经量、月经间期出血时间、不规则阴道流血或点滴出血的发生率均显著低于对照组,差异有统计学意义(P<0.05);观察组和对照组不良反应的发生率分别为21.3%和25.5%,差异无统计学意义(P>0.05)。结论:LNG-IUS联合米非司酮治疗子宫腺肌病的近远期疗效确切,可有效减少不规则阴道出血。

Objective： To explore the short-term and long-term effect and safety of levonorgestrel-releasing intrauterine system （LNG-IUS） combined with mifepristone for uterine adenomyosis. Methods： A total of 94 patients with uterine adenomyosis were randomly divided into two groups. Observation group was inserted LNG-IUS and given mifepristone once a month, 6 months for a course of treatment; Control group was only inserted LNG-IUS. The short-term, the 1st, 3rd and 5th year after treatment, and adverse effect were observed and compared between the two groups. Results： After treatment, the total effective rate in observation group and control group was 91.5% and 87.2%,respectively,without significant differences（P〉0.05）. During the 5-year follow-up, the menstrual cycle, menstruation, bleeding time between menstrual periods and incidence of irregular vaginal bleeding or bit bleeding in the observation groups were significantly lower than those in the control group with significant differences （P〈0.05）. The rate of adverse effect in the observation group and the control group was 21.3% and 25.5%, respectively, without significant differences （P〉0.05）. Conclusions： LNG-IUS combined with mifepristone for uterine adenomyosis can achieve good short-term and long-term effect, and reduce irregular vaginal bleeding.