曼月乐治疗子宫肌瘤的临床疗效研究

Clinical Analysis of Effect of Mirena on Uterine Myomas

目的观察子宫肌瘤患者放置曼月乐(左炔诺孕酮宫内缓释系统)的临床效果。方法选取40例患子宫肌瘤同时伴月经过多、中度以上贫血、不愿接受手术治疗的患者,观察放置前、放置后6个月及12个月的子宫容积、子宫肌瘤大小、月经量PBAC评分,并检测血红蛋白,子宫内膜厚度等。结果①曼月乐放置6、12个月后子宫体积明显缩小,与治疗前比较差异有统计学意义(P<0.01);②月经量PBAC评分在放置曼月乐后6和12个月比较差异均有统计学意义(P<0.01);③曼月乐放置后血红蛋白值升高,与治疗前比较差异有统计学意义(P<0.01);④曼月乐放置后子宫内膜厚度较放置前变薄,放置前后比较有统计学意义(P<0.01);⑤曼月乐放置后子宫肌瘤有缩小趋势,但与放置前比,差异无统计学意义(P>0.05);⑥曼月乐放置后肝、肾功能均未见异常。结论曼月乐治疗子宫肌瘤可有效缩小子宫体积,减少月经量,改善贫血,降低子宫内膜厚度,同时不增加子宫肌瘤大小,因此,用曼月乐治疗子宫肌瘤是安全、有效的,值得临床推广。

Objective To investigate the clinical effect of mirena （levonorgestrel - releasing intrauterine systemn ） in the treatment of uterine myomas. Methods Forty patients with uterine leiomyoma accompanied by menorrhagia and moderate or severe anemia, who refused to surgery, were involved in present study. The uterus volume, tumor size, the menstrual blood volume were observed and as- sessed by PABC scale. Hemoglobin level, endomrtaial thickness were determined before and 6 and 12 months after Mirena being applied. Results The uterine volume decreased 6 and 12 months after mirena being applied （P 〈 0.01 ）. There was significant difference between mean PBAC scores before and 6 and 12 months after treatment（P 〈 0.01 ）. Hemoglobin of all cases was significantly increased after treat- ment （ P 〈 0.01 ）. The endometrial thickness was reduced after mirena being applied （ P 〈 0.01 ）. The myoma volume was decreased after treatment, but no significant difference was found （ P 〉 0.05 ）. The function of liver and kidney was normal after treatment （ P 〉 0.05 ）. Conclusion Mirena can decrease the uterine volume and the menstrual blood loss, improve anemia, reduce the endometrial thickness, meanwhile, it would not increase the myoma volume. Treatment of mirena for the patients of uterine myomas is safe and effective. It should be applied widely.