左炔诺孕酮宫内释放系统治疗子宫腺肌病的下移率及其相关因素的分析

目的评估左炔诺孕酮宫内缓释系统(曼月乐,LNG-IUS)治疗子宫腺肌病的下移率及其危险因素。方法收集2016年1月至2018年1月在北京医院妇产科因子宫腺肌病使用LNG-IUS治疗的87例住院患者的临床资料,并按照LNG-IUS的位置变化分为正常组(79例)和和下移组(8例)。比较LNG-IUS放置前后两组患者月经量的变化,观察LNG-IUS是否发生移位或脱出及其对月经量的影响。结果 87例患者平均年龄(43.1±4.8)岁,平均经量评分(155.9±89.6)。其中8例(9.2%)患者出现节育器下移。LNG-IUS放置前,位置正常组与下移组经量评分[(151.8±83.5)vs.(197.4±90.4)]有统计学差异(P<0.05)。置入LNG-IUS后,正常组和下移组经量均较放置前减少,放置后3个月经量显著减少,6个月效果更显著[(151.8±83.5)vs.(44.3±16.1),(197.4±90.4)vs.(80.7±51.6)],但下移组在不同时间点的经量评分均与正常组有显著性差异(P<0.05)。结论 LNG-IUS可有效减少子宫腺肌病患者的月经量及子宫体积,...

Down-shifted rate of levonorgestrel releasing system in treatment of adenomyosis and its influence on therapeutic effect

Objective:To evaluate down-shifted rate of levonorgestrel releasing system(LNG-IUS)in treatment of adenomyosis and its influence on therapeutic effect.Methods:The clinical data of 87 patients with adenomyosis treated by LNG-IUS in Beijing Hospital from January 2016 to January 2018 were analyzed retrospectively.According to whether LNG-IUS shifted down,the patients were divided into two groups:normal group(n=79)and down-shifted group(n=8).The changes of menstrual volume before and after LNG-IUS placement in the two groups were analyzed,and whether LNG-IUS shifted down and its effect on the therapeutic effect was observed.Results:The mean age of the participants was(43.1±4.8)years.The mean menstrual blood loss by PBAC was(155.9±89.6).Among the participants,eight(9.2%)had LNG-IUS down-shifted.Before LNG-IUS placement,the menstrual volume of the normal group was significantly lower than that of the down-shifted group[(151.8±83.5)vs.(197.4±90.4),P<0.05].After placement of LNG-IUS,the menstrual volume of the normal group and the down-shifted group decreased significantly compared with that before placement,and the menstrual volume decreased significantly in three months after placement,especially in the six months(P<0.05),and the menstrual scores at different time points in the down-shifted group were significantly different from those in the normal group.Conclusions:LNG-IUS can effectively reduce the amount of menstruation and the uterine volume of patients with adenomyosis,menorrhagia is a risk factor for the down-shifted of LNG-IUS,which can reduce effect of improving menstrual volume.