释放左炔诺孕酮的宫内节育器治疗子宫腺肌病

目的　探讨释放左炔诺孕酮的宫内节育器治疗子宫腺肌病的疗效和安全性。方法　观察32例子宫腺肌病患者放置释放左炔诺孕酮的宫内节育器前后痛经症状、月经情况、子宫体积、血清CA12 5和不良反应。结果　患者放置释放左炔诺孕酮的宫内节育器1个月后痛经程度明显减轻,痛经程度评分由放置前的2 7分降为放置1个月后的0 7分(P <0 0 1) ,放置3个月后所有患者的痛经症状消失。子宫体积于放置6个月后稍缩小,但不明显(P >0 0 5 ) ,以后变化也不明显。血清CA12 5于放置3个月后明显降低(P <0 0 1) ,且降至正常范围,以后维持在较低的水平。结论　释放左炔诺孕酮的宫内节育器治疗子宫腺肌病安全有效,为一种较好的保守治疗手段。

Treatment of adenomyosis with a Levonorgestrel-releasing intrauterine device

Objective To evaluate the efficacy and safety of a Levonorgestrel-releasing intrauterine device (LNG-IUD) in treatment of adenomyosis.Methods To observe and compare the symptoms of dysmenorrhea,serum CA 125 ,volume of uterus,patterns of menstruation,and side-effect before and after LNG-IUD was inserted.Results The symptom of dysmenorrhea was relieved significantly one month after insertion,scores of pain decreased from 2.7 to 0.7(P<0.01),and disappeared six month after insertion.The volume of uterus reduced six months after insertion and later,but without significant change (P>0.05).Serum CA 125 reduced significantly(P<0.01),down to the normal range three months after insertion,and remained at low level later.Conclusions Treatment of adenomyosis with a Levonorgestrel-releasing intrauterine device is a safe and effective conservative method.