左炔诺孕酮宫内缓释系统在子宫内膜异位症治疗中的作用

Effect of levonorgestrel-releasing intrauterine system in the treatment of endometriosis

目的探讨左炔诺孕酮宫内缓释系统(levonorgestrel-releasing intrauterine system,LNG-IUS)在子宫内膜异位症治疗中的作用。方法选取2014年2月至2015年6月于本院行保守手术治疗的子宫内膜异位症患者86例为研究对象,按照随机数表法将其分为观察组和对照组,每组各43例。术后给予对照组患者孕三烯酮治疗,予观察组患者LNG-IUS治疗。比较两组患者的疗效、复发情况、治疗前后血清高敏C反应蛋白(hs-CRP)和血管内皮生长因子(VEGF)水平的变化情况。结果治疗6个月后,观察组患者显效18例,有效22例,无效3例,治疗总有效率为93.02%;对照组患者显效13例,有效21例,无效9例,治疗总有效率为79.07%。观察组患者治疗总有效率明显高于对照组(P<0.05)。随访发现观察组仅1例(2.33%)复发,对照组7例(16.28%)复发,观察组复发率明显低于对照组(P<0.05)。治疗后,两组患者血清hs-CRP和VEGF水平均较治疗前明显降低(P<0.05);观察组患者血清hs-CRP和VEGF水平均明显低于对照组(P<0.05)。结论子宫内膜异位症术后应用LNG-IUS治疗效果佳,复发率低,值得推广应用。

Objective To investigate the effect of levonorgestrel-releasing intrauterine system（LNG-IUS） in the treatment of endometriosis. Method From February 2014 to June 2015, 86 cases of endometriosis patients underwent conservative surgeries in our hospital were envoloved in the study. They were divided into observation group and control group according to a random number table method, 43 cases in each group. Patients in control group were given postoperatively gestrinone treatment, observation group patients were treated with LNG-IUS. Compared the efficacy, recurrence, levels of serum high sensitivity C-reactive protein（hs-CRP） and vascular endothelial growth factor（VEGF） before and after treatment between the two groups. Result After 6-month treatment, 18 cases in observation group reached marked effect and 22 cases were effective and 3 cases were ineffective, total effective rate was 93.02%; in control group, 13 cases were markedly effective and 21 cases were effective and 9 cases were ineffective, the total effective rate was 79.07%. The total effective rate of observation group was significantly higher than control group（P〈0.05）. During the followup, 1 case（2.33%） of recurrence in observation group; 7 cases（16.28%） of recurrence in control group. The recurrence rate of observation group was significantly lower than control group（P〈0.05）. After treatment, the levels of serum hs-CRP and VEGF had significantly decreased in both groups. And these two indexes in observation were significantly lower than control group（P〈0.05）. Conclusion Postoperative LNG-IUS of endometriosis surgeries have good curative effect, low recurrence rate, deserving wide application.