左炔诺孕酮宫内缓释系统治疗子宫腺肌病临床观察

Effect of levonorgestrel releasing intrauterine system on the treatment of adenomyosis

目的:观察左炔诺孕酮宫内缓释系统(LNG-IUS)应用于子宫腺肌病治疗中的临床价值,探究其临床疗效和安全性,为今后临床提供参考。方法:选取2011年1月至2013年12月期间门诊收入治疗的子宫腺肌病87例患者为研究对象,根据患者意愿将其分为对照组42例、治疗组45例。对照组予以孕三烯酮治疗,治疗组给予LNG-IUS。比较治疗后一般情况。结果:治疗前后,对照组的血清激素水平较治疗组变化更显著;治疗后组间在各激素水平相比差异显著(P<0.05);置放前,两组子宫内膜厚度无统计学意义;3个月后比较差异显著(P<0.05);6、12、24个月后,差异均显著(P均<0.01);与放置前比较,患者痛经评分、月经量、血红蛋白水平在置放3、6、12个月后具有显著差异(P<0.01);子宫体积、血红蛋白以及血清CA-125水平均有明显变化(P<0.01)。结论:左炔诺孕酮宫内缓释系统可有效改善子宫腺肌病症状,有利于控制AM进展,安全、有效,值得进一步研究。

Objectives： To observe the effect of levonorgestrel releasing intrauterine system（ LNG- IUS） in the treatment of uterine adenomyosis,and to explore the clinical efficacy and safety,providing reference for future clinical application. Methods： 87 patients with adenomyosis admitted by outpatient service from January 2011 to December 2013 were selected as research subjects,who were divided into the treatment group（ n = 45） and the control group（ n = 42） according to their willingness. The control group was given gestrinone for treatment,while the treatment group was given LNG- IUS. The general treatment effects were compared. Results： Changes in serum hormone level after treatment was more significant in the control group compared with the treatment group,all P〈0. 05.Difference in the endometrial thickness between the two groups before treatment was not statistically significant,but statistically significant after three months（ P〈0. 05）,for 6,12,24 months later P〈0. 01. The dysmenorrhea score,menstrual blood volume and hemoglobin levels 3,6,12 months after the placement were significantly different from those before（ P 〈0. 001）; and the uterine volume,hemoglobin and serum CA125 level showed significant changes with statistical significance（ P 〈0. 001）. Conclusion： Levonorgestrel- releasing intrauterine system can effectively improve the symptoms of adenomyosis,and help to control the progression of AM,which is safe and effective,worthy of further study.