促性腺激素释放激素激动剂联合左炔诺孕酮宫内缓释系统治疗子宫腺肌病患者的临床效果

Clinical effect of gonadotropin-releasing hormone agonist combined with Levonorgestrel Intrauterine Sustained-release System in patients with adenomyosis

目的评价促性腺激素释放激素激动剂(GnRH-a)联合左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫腺肌病的临床效果及不良反应。方法选取2019年10月至2021年10月就诊于德州市妇幼保健院的80例子宫腺肌病患者作为研究对象,按照随机数字表法分为对照组和观察组,各40例。对照组给予LNG-IUS治疗;观察组给予GnRH-a与LNG-IUS联合治疗,比较两组患者的子宫体积、血红蛋白水平、糖类抗原125(CA125)水平、视觉模拟评分法(VAS)评分及不良反应。结果观察组治疗后的子宫体积小于对照组,血红蛋白水平、VAS评分、CA125水平低于对照组,差异有统计学意义(P<0.05)。两组患者的体重增加、情绪抑郁、睡眠障碍、节育器下移/脱落发生率比较,差异无统计学意义(P>0.05);观察组的潮热出汗、阴道干涩发生率高于对照组,阴道不规则流血发生率低于对照组,差异有统计学意义(P<0.05);两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论GnRH-a联合LNG-IUS对子宫腺肌病的治疗效果较好,具有较高的临床应用价值,二者联合使用不良反应多以更年期相关症状为主。

Objective To evaluate the clinical efficacy and adverse reactions of gonadotropin-releasing hormone agonist(GnRH-a)combined with Levonorgestrel Intrauterine Sustained-release System(LNG-IUS)in the treatment of adenomyosis.Methods A total of 80 patients with adenomyosis admitted to Dezhou Maternal and Child Health Hospital from October 2019 to October 2021 were selected as research objects,and they were divided into control group and observation group according to random number table method,with 40 cases in each group.The control group was treated with LNG-IUS.Observation group was treated with GnRH-a and LNG-IUS.Uterine volume,hemoglobin level,carbohydrate antigen 125(CA125)level,visual analogue scale(VAS)score and adverse reactions were compared between the two groups.Results The uterine volume of the observation group after treatment was smaller than that of the control group,and the hemoglobin level,VAS score and CA125 level were lower than that of the control group,with statistical significances(P<0.05).There were no significant differences in the incidence of weight gain,mood depression,sleep disorders and IUD downshift/detachment between two groups(P>0.05).The incidence of hot flashes,sweating and vaginal dryness in the observation group was higher than that in the control group,and the incidence of irregular vaginal bleeding was lower than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between two groups(P>0.05).Conclusion GnRH-a combined with LNG-IUS has a good therapeutic effect on adenomyosis and has high clinical application value.The adverse reactions of the combined use of GnRh-A and LNG-IUS are mainly related to menopause symptoms.