左炔诺孕酮宫内缓释系统对功能失调性子宫出血治疗效果的初步观察

目的观察左炔诺孕酮宫内缓释系统（曼月乐）对功能失调性子宫出血的临床疗效。方法对58例子宫内膜诊刮病理诊断为功能失调性子宫出血患者放置曼月乐,在放置前和放置满24个月内定期B超监测子宫内膜厚度,观察患者血红蛋白情况、置环后病理变化及月经改善情况。结果置环前子宫内膜厚度为（16.5±7.3）mm,置环24个月子宫内膜厚度为（3.1±1.4）mm,两者比较有显著性差异（P〈0.05）;放置曼月乐6个月后患者血红蛋白显著升高（98.5±13.1）vs（123.0±8.4）g/L,P〈0.05];置环后病理变化显示子宫内膜增生过长的表现消失。结论曼月乐不但能从临床方面有效地控制月经,对功血有持续的疗效,对增生过长的子宫内膜也有抑制作用。

Effect of the levonorgestrel - releasing intrauterine device (Mirena)in the treatment of dysfunctional uterine bleeding

Objective To evaluate the efficacy and side - effect of the levonorgestrel - releasing intrauterine device （Mirena） with progesterone in the treatment of dysfunctional uterine bleeding. Methods 58 cases of dysfunctional uterine bleeding with pathologic diagnosis were inserted Mirena and the endometrial thickness by ultrasound ,bemoglobulin increasing and pathologic changes of endometria were detected before and after the insertion twenty - four months . Re- suits The endometrial thickness before and after the insertion of Mirena were （ 16.5 ＋ 7.3 ） mm and （3.1 ＋_ 1.4） mm respectively,which had a significant difference between them. After the insertion of Mirena, patients＇ hemoglobulin was in- creased, and there was a significant difference between before and after insertion . After the insertion of Mirena , pathologic results showed it would reverse the endometrial hyperplasia . Conclusions Mirena is an effective and continual therapy for dysfunctional uterine bleeding. It can not only significantly reduce the menstrual blood loss but also reverse the endometrial hyperplasia effectively.