左炔诺孕酮宫内缓释系统治疗子宫腺肌病的临床观察

Clinical efficacy of levonorgestrel- releasing intrauterine system in the treatment of adenomyosis

目的观察左炔诺孕酮宫内缓释系统(LNG-IUS,商品名:曼月乐)治疗子宫腺肌病的临床疗效。方法对46例子宫腺肌病患者宫腔放置LNG-IUS,并对其放环前及放环后第1、3、6、12月随诊观察比较痛觉视觉模拟评分、月经量、子宫体积、CA125、血清生殖激素水平和术前后综合心理健康指数。结果 LNG-IUS治疗子宫腺肌病12个月的VAS评分由放置前(7.2±2.1)分降至(2.6±1.3)分,月经量由放置前的(167.0±25.0)ml降至(31.0±7.0)ml,子宫体积由放置前的(181±31)cm3降至(106±15)cm3,CA125由放置前的(177±35)U/L降至(24±7)U/L,差异显著有统计学意义(P<0.01)。PGWBI由放置前的(61.2±13.0)升至(83.3±15.5),差异显著有统计学意义(P<0.01)。结论宫内放置左炔诺孕酮宫内缓释系统治疗子宫腺肌病是一种疗效显著的治疗方法,能显著提高患者生活质量。

Objective To observethe clinical efficacy of levonorgestrel- releasing intrauterine system in the treatment of adenomyosis. Methods Forty- six cases of uterine adenomyosis patients were placed with LNG- IUS in uterine cavity. Pain visual analog scale（ VAS）,menstrual flow,uterine volume,CA125,serum reproductive hormone levels and comprehensive mental health index（ PGWBI） before and 1st,3rd,6th,12 th month after placing LNG- IUS were compared. Results After a 12- month- follow- up,VAS score dropped from（ 7.2 ± 2. 1） to（ 2. 6 ± 1. 3） points,the amount of menstrual droppedfrom（ 167 ± 25） m L to（ 31 ± 7） m L,and the volume of uterine dropped from（ 181 ± 31） cm3to（ 106 ± 15） cm3,CA125 dropped from（ 177 ± 35） U / L to（ 24 ± 7） U/L,and the differences were statistically significant（ P〈0. 01）. The PGWBI significantly increased from（ 61. 2 ± 13. 0） to（ 83. 3 ± 15. 5）（ P〈0. 01）. Conclusions Placingintrauterine levonorgestrel releasing system is an effectivemethod in the treatment of adenomyosis,which can significantly improve the quality of life.