左炔诺孕酮宫内缓释系统临床应用及疗效评价

Clinical Application and Evaluation of Levonorgestrel-releasing Intrauterine System

目的:探讨左炔诺孕酮宫内缓释系统(LNG-IUS)临床应用及发生下移后上推复位的效果。方法:对152例放置LNG-IUS患者进行随访,了解痛经程度、月经量变化及LNG-IUS在宫腔的位置。对45例LNG-IUS下移者采用超声引导上推复位术。结果:放置LNG-IUS第6个月与放置前比较视觉模拟评分法(VAS)评分和失血量图形分析评分法(PBAC)评分差异有统计学意义(t=2.15,P<0.05;t=142.63,P<0.01)。LNG-IUS下移45例(29.6%),经上推复位治疗后,42例仍继续使用。结论:LNG-IUS是治疗功能性子宫出血及子宫腺肌病相关疼痛及月经过多的有效方法之一。LNG-IUS使用中下移经超声引导上推复位术是安全可行的。

Objective： To observe the clinical application of levonorgestrel-releasing intrauterine system（LNG-IUS）,and to evaluate the effeciency of resetting the downward shifted LNG-IUS.Methods：Total 152 patients with LNG-IUS were follow-up visited,to assess the degree of dysmenorrheal,the extent of menstrual bleeding and the position of LNG-IUS in uterine.The reposition under the guidance of B ultrasound were performed in 45 cases with ectopic LNG-IUS.Results：Both VAS grade and PBAC grade after inserting the LNG-IUS were significantly lowered when compared with their pre-deposited grades（t=2.15,P〈0.05;t=142.63,P〈0.01）.Of the 45 cases undergoing reposition（29.6%）,42 cases were still using the device.Conclusions： LNG-IUS is one of the effective treatments for dysfunctional uterine bleeding and adenomyosis of uterus.The reposition of the downward shifted LNG-IUS under the guidance of B ultrasound is safe and feasible.