宫腔镜曼月乐环固定术治疗子宫腺肌病临床效果分析

Clinical efficacy analysis of hysteroscopic fixation of Mirena IUD in the treatment of adenomyosis

目的 探讨宫腔镜曼月乐环固定术治疗子宫腺肌病的临床疗效。方法 选取淮安市第五人民医院妇科2022年1—11月84例子宫腺肌病患者作为研究对象,用随机数表法分为对照组42例、观察组42例,对照组注射戈舍瑞林+宫内置曼月乐环;观察组行宫腔镜下曼月乐环固定术,月经周期第1~5天给予促性腺激素释放激素类似物(GnRH-a)。比较两组生活质量综合评定问卷-74(GQOLI-74)、血红蛋白、雌二醇、痛经症状、不良反应、临床疗效。结果 治疗后观察组患者的情感职能、社会功能、躯体功能、生理功能评分、血红蛋白高于对照组(P <0.05);观察组患者的雌二醇水平低于对照组(P <0.05)。观察组患者腹部下坠感、腰酸、背痛、恶心痛经症状总发生率低于对照组(P <0.05)。观察组患者阴道出血、头痛、脱环不良反应总发生率低于对照组(P <0.05)。观察组患者临床总有效率高于对照组(P <0.05)。结论 采用宫腔镜曼月乐环固定术治疗,可改善子宫腺肌病患者血红蛋白、雌二醇水平,提高患者生活质量,降低痛经症状、不良反应,临床使用效果较好。

Objective To explore the clinical efficacy of hysteroscopic fixation of Mirena IUD in the treatment of adenomyosis.Methods A total of 84 patients with adenomyosis admitted to and treated in the Gynecology Department of the Fifth People's Hospital of Huai'an from January to November 2022 were selected as the study subjects.They were randomly divided into a control group of 42 cases and an observation group of 42 cases using a random number table method.The control group received injection of Goserelin and intrauterine Mirena IUD.The observation group received hysteroscopic fixation of Mirena IUD.The observation group received hysteroscopic fixation of Mirena IUD,Gonadotropin releasing hormone analogues(GnRH-a) was injected subcutaneously on the 1st-5th days of menstrual cycle.The results of generic quality of life inventory-74(GQOLI-74),hemoglobin,estradiol,dysmenorrhea symptoms,adverse reactions,and clinical efficacy were compared between the two groups.Results The emotional function,social function,physical function and physiological function scores,and hemoglobin level of the observation group after treatment were higher than those of the control group(P < 0.05).The levels of estradiol in the observation group were lower than those in the control group(P < 0.05).The total incidence of abdominal sagging,low back pain,back pain,nausea and dysmenorrhea symptoms in the observation group was lower than that in the control group(P < 0.05).The total incidence of vaginal bleeding,headache,and adverse reactions to IUD removal in the observation group was lower than that in the control group(P < 0.05).The total clinical efficacy rate of the observation group was higher than that of the control group(P < 0.05).Conclusion The use of hysteroscopic fixation of Mirena IUD can improve the levels of hemoglobin and estradiol in patients with adenomyosis,improve their quality of life,reduce dysmenorrhea symptoms and adverse reactions,and achieve good clinical results.