左炔诺孕酮宫内缓释系统治疗子宫腺肌病的临床疗效研究

Clinical observation of levonorgestrel intrauterine system in the treatment of adenomyosis

目的:探讨左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫腺肌病(AM)的临床疗效。方法:对67例AM患者子宫内放入LNG-IUS,检测放置前、放置后1、3、6、12、24个月的月经量、痛经情况、子宫内膜厚度、子宫体积以及血清中的血红蛋白(Hb)、促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E_2)等指标的变化。结果:放置LNG-IUS后,患者的月经量在3个月后较放置前明显减少(P<0.05),痛经在放置3个月后较放置前明显减轻(P<0.05),子宫内膜厚度在放置1个月后较放置前明显变薄(P<0.05),子宫体积在放置1年后明显缩小(P<0.05),血清Hb水平在放置6个月后较放置前明显上升(P<0.05),血清FSH、LH、E_2水平放置前、后无统计学差异(P>0.05)。结论:LNG-IUS能有效缓解AM患者痛经、减少月经量、改善子宫内膜厚度并在一定程度上缩小子宫体积、提高血清Hb水平,且不会影响患者卵巢功能,是治疗AM的一种有效方法。

Objective： To investigate the clinical efficacy of levonorgestrel intrauterine system （LNG-IUS） on the treatment of adenomyosis （AM）. Methods： LNG-IUS was placed in 67 patients with AM. Menstrual flow, dysmenorrheal, uterine endometrial thickness, uterine volume, level of hemoglobin, follicle-stimulating hormone （FSH）, luteinizing hormone （LH）, estradiol （E2） were compared between before treatment and 1 month, 3 months, 6 months, 12 months, 24 months after treatment. Results： The parameters of menstrual flow and dysmenorrhea at 3 months after treatment, uterine endometrial thickness at 1 month after treatment, uterine volume at 12 months after treatment were lower than those before treatment with statistically significant differences （P〈0.05）. Level of hemoglobin at 6 months after treatment was higher than that before treatment with a statistically significant difference （P〈0.05）. Levels ofFSH, LH, E2 after treatment were similar to those before treatment with no statistical difference （P〉0.05）. Conclusion： LNG-IUS has an effect on relieved dysmenorrhea, reduced menstrual flow, uterine endometrial thickness and uterine volume, increased level of hemoglobin, but didn＇t affect the ovarian function, which is an effective method to cure AM.