第二代子宫内膜消融术可提高左炔诺孕酮宫内节育系统对子宫腺肌病患者的疗效

The second generation endometrial ablation (NovaSure) improves efficacy of levonorgestrel-releasing intrauterine system in management of adenomyosis

目的:探讨第二代子宫内膜消融术(诺舒)联合左炔诺孕酮宫内节育系统(曼月乐)治疗子宫腺肌病的疗效。方法:回顾性分析2015年1月至2018年12月在浙江大学医学院附属妇产科医院接受单独曼月乐治疗(对照组,44例)和诺舒联合曼月乐治疗(观察组,22例)的子宫腺肌病患者的月经量、痛经改善情况、子宫大小、曼月乐脱落事件和患者满意度。结果:与治疗前比较,两种治疗均可改善患者月经量和痛经(均P<0.05);与对照组比较,观察组患者月经量改善更明显,曼月乐脱落事件发生率更低、患者满意度更高(均P<0.05);两组间的痛经评分和子宫大小变化无差异(均P>0.05)。结论:诺舒有助于提高曼月乐在子宫腺肌病患者中的疗效。

Objective: To determine the efficacy of second generation endometrial ablation(NovaSure) combined with levonorgestrel-releasing intrauterine system(Mirena) in the treatment of adenomyosis. Methods: Clinical data of patients with adenomyosis admitted in Women’s Hospital, Zhejiang University School of Medicine from January 2015 to December 2018 were retrospectively analyzed. Among 66 patients, 44 received Mirena placement only(control group) and 22 received Mirena placement and NovaSure treatment(study group). The menstruation blood loss, dysmenorrhea score, uterine size, expulsion rate of Mirena and the patients’ satisfaction rate were assessed in two groups. Results: There was a significant reduction in menstruation blood loss(P<0.05) and significant improvement in dysmenorrhea(P<0.05) after the treatment in both groups. The patients in study group had more marked improvement in menstruation blood loss than those in control group(P<0.05). The patients’ satisfaction was higher and the expulsion rate of Mirena was lower in study group than that in control group(all P<0.05). The score of dysmenorrhea and the size of uterine had no significant difference between two groups(all P>0.05). Conclusion: NovaSure can improve the efficacy of Mirena in treatment of adenomyosis.