左炔诺孕酮宫内缓释系统治疗子宫肌瘤70例疗效观察

目的探讨左炔诺孕酮宫内缓释系统（曼月乐）治疗子宫肌瘤并月经过多患者的临床效果。方法子宫肌瘤并月经过多患者70例，34例行宫腔镜下电切术者于术后第1个月经周期的第5～7天放置曼月乐，36例未行宫腔镜电切术者即时放置曼月乐，观察放置前及放置后1、3、6、12个月患者月经量、子宫肌瘤直径、子宫体积变化。结果与放置前（（160±47）mL）比较，放置曼月乐后第1个月月经量开始减少（（80±20）mL），至第12个月后月经量明显减少（（40±13）mL），差异均有统计学意义（P〈0．05）；放置曼月乐后第12个月子宫体积（（113±25）cm3）及子宫肌瘤直径（2．9±0．7）cm较放置前（（160±57）cm3、（3．6±0．4）cm）缩小（P〈0．05）。结论宫内放置曼月乐可有效减少子宫肌瘤并月经过多患者月经量，缩小子宫肌瘤直径及子宫体积。

Clinical observation of levonorgestrel-releasing intrauterine system in the treatment of hysteromyoma

Objective To investigate the therapeutic effect of levonorgestrel-releasing intrauterine system on hysteromyoma complicated with menorrhagia. Methods Seventy hysteromyoma patients complicated with menorrhagia underwent hysteroscopy, in which 34 patients undergoing electrotomy were placed levonorgestrel-releasing intrauterine system by day 5 to 7 in the first menstrual cycle after electrotomy, and 36 patients were placed levonorgestrel-releasing intrauterine system during hysteroscopy. All patients were observed menstrual blood volume, diameter of hysteromyoma and uterine volume before treatment and 1, 3, 6 and 12 months after treatment. Results The menstrual blood volume decreased from （160±47） mL before treatment to （80±20） mL one month after treatment and （40±13） mL 12 months after treatment （P（0.05）. The uterine volume and diameter of hysteromyoma decreased from （160±57） cm3 and （3.6± 0.4） cm before treatment to （113±25） cm3 and （2. 9±0. 7） cm 12 months after treatment （P（0.05）. Conclusions Levonorgestrel-releasing intrauterine system can reduce menstrual blood volume, diameter of hysteromyoma and uterine volume in hysteromyoma patients complicated with menorrhagia.