左炔诺孕酮宫内缓释系统联合促性腺激素释放激动剂治疗子宫内膜异位症的临床效果

Clinical effect of LNG-IUS combined with GnRH-a in the treatment of endometriosis

目的探讨左炔诺孕酮宫内缓释系统联合促性腺激素释放激动剂治疗子宫内膜异位症的临床效果。方法将96例子宫内膜异位症患者分为LNG-IUS组、GnRH-a组及联合组3组,每组各32例,LNG-IUS组与GnRH-a组分别单独采用左炔诺孕酮宫内缓释系统与促性腺激素释放激动剂进行治疗,联合组则联合两种方法进行治疗。结果 GnRH-a组与联合组的1年临床总有效率均为100.0%,显著高于LNG-IUS组的87.5%(P<0.05)。GnRHa组2年复发率为35.3%,显著高于LNG-IUS组的8.3%和联合组的13.3%(P<0.05);GnRH-a组与联合组的2年复发率比较差异无统计学意义(P>0.05)。随访1年,GnRH-a组与联合组的骨密度与治疗前比较差异有统计学意义(P<0.05);随访2年,3组的骨密度与治疗前比较差异无统计学意义(P>0.05)。结论左炔诺孕酮宫内缓释系统联合促性腺激素释放激动剂治疗子宫内膜异位症的整体效果较两者单独使用时更显著,其联合用药方案可作为临床治疗子宫内膜异位症的首选。

Objective To investigate clinical effect of levonorgestrel-releasing intrauterine system （LNG-IUS）combined with gonadotropin releasing agonist（GnRH-a）in the treatment of endometriosis. Methods 96 patients with endometriosis were divided into LNG-IUS group,GnRH-a group and combined group,each group of 32 cases.LNG-IUS and GnRH-a was used in LNG-IUS group and GnRH-a group respectively,and combined with two treatment methods were applied in combined group. Results 1 year clinical total effective rate of GnRH-a group and combined group was 100.0% respectively,significantly higher than that of LNG-IUS group respectively （87.5%） （P〈0.05）.2 years recurrence rate of GnRH-a group was 35.3%,significantly higher than that of LNG-IUS group（8.3%）and combined group（13.3%） respec-tively （P〈0.05）,while 2 years recurrence rate of GnRH-a group compared with combined group had no statistical difference（P〉0.05）.Follow-up of 1 year,bone mineral density of GnRH-a group and combined group compared with before treatment respectively,with statistical difference（P〈0.05）.Follow-up of 2 year,bone mineral density of three groups com-pared with before treatment respectively,with no statistical difference （P〉0.05）. Conclusion The integral effect of LNG-IUS combined with GnRH-a in the treatment of endometriosis is more significant than when they are used alone,combi-nation scheme can be used as a clinical choice in the treatment of endometriosis.