左炔诺孕酮宫内缓释系统治疗子宫腺肌病的临床疗效研究

目的:探讨左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫腺肌病(AM)的临床疗效。方法:对67例AM患者子宫内放入LNG-IUS,检测放置前、放置后1、3、6、12、24个月的月经量、痛经情况、子宫内膜厚度、子宫体积以及血清中的血红蛋白(Hb)、促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E_2)等指标的变化。结果:放置LNG-IUS后,患者的月经量在3个月后较放置前明显减少(P0.05),痛经在放置3个月后较放置前明显减轻(P0.05),子宫内膜厚度在放置1个月后较放置前明显变薄(P0.05),子宫体积在放置1年后明显缩小(P0.05),血清Hb水平在放置6个月后较放置前明显上升(P0.05),血清FSH、LH、E_2水平放置前、后无统计学差异(P0.05)。结论:LNG-IUS能有效缓解AM患者痛经、减少月经量、改善子宫内膜厚度并在一定程度上缩小子宫体积、提高血清Hb水平,且不会影响患者卵巢功能,是治疗AM的一种有效方法。

Clinical observation of levonorgestrel intrauterine system in the treatment of adenomyosis

Objective:To investigate the clinical efficacy of levonorgestrel intrauterine system (LNG-IUS) on the treatment of adenomyosis (AM).Methods:LNG-IUS was placed in 67 patients with AM.Menstrual flow,dysmenorrheal,uterine endometrial thickness,uterine volume,level of hemoglobin,follicle-stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2) were compared between before treatment and 1 month,3 months,6 months,12 months,24 months after treatment.Results:The parameters of menstrual flow and dysmenorrhea at 3 months after treatment,uterine endometrial thickness at 1 month after treatment,uterine volume at 12 months after treatment were lower than those before treatment with statistically significant differences (P＜0.05).Level of hemoglobin at 6 months after treatment was higher than that before treatment with a statistically significant difference (P＜0.05).Levels ofFSH,LH,E2 after treatment were similar to those before treatment with no statistical difference (P＞0.05).Conclusion:LNG-IUS has an effect on relieved dysmenorrhea,reduced menstrual flow,uterine endometrial thickness and uterine volume,increased level of hemoglobin,but didn't affect the ovarian function,which is an effective method to cure AM.