左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫腺肌病2年临床观察

目的:探讨左炔诺孕酮宫内缓释系统(LNG-IUS,商品名:曼月乐)治疗子宫腺肌病(adenomyosis,AM)的临床疗效及不良反应。方法:观察58例子宫腺肌病患者LNG-IUS放置前、放置后1个月、3个月、6个月、12个月、18个月、2年的痛经视觉模拟评分法(VAS)评分、月经量、血清CA125、子宫体积和内膜厚度及相关不良反应。结果:LNG-IUS放置后患者痛经明显缓解,VAS评分明显下降,月经量明显减少,子宫内膜变薄,并持续保持疗效,与放置前相比较,差异均有统计学意义(P<0.01);在一定程度上,子宫体积缩小,CA125降低,但差异均无统计学意义(P>0.05)。不良反应主要为阴道少许点滴出血,充分解释后患者多能接受;另有少量脱环、功能性卵巢囊肿、闭经、痤疮等。结论:LNG-IUS是治疗子宫腺肌病的一种有效的保守治疗方法,适合用于痛经和/或月经过多的子宫腺肌病患者。

The 2-Year Observation of Clinical Effect of Levonorgestrel-Releasing Intrauterine System on the Treatment of Adenomyosis

Objective: To investigate the clinical evaluation and side effects of levonorgestrel-releasing intrauterine system(LNG-IUS) on the treatment of adenomyosis.Methods: Fifty-eight cases of adenomyosis treated with LNG-IUS were followed up and the change of dysmenorrhea VAS score,menstrual volume,serum CA125 level,volume and membrane of uterus and associate side effects before and after 1,3,6,12,18 and 24 months insertion were observed respectively.Results: After insertion of LNG-IUS,the dysmenorrhea VAS scores,and menstrual volume were decreased uterus membrane markedly and persistently.Compared with the treatment before,the differences were statistically significant(P<0.01).The volume of uterus and serum CA125 level reduced to some extent,while there were no statistical differences(P>0.05).The main side effect was little vaginal bleeding which most patients can accept after explained abundantly.There were some other side effects observed,such as Mirena-dropping-out,functional ovarian cysts,amenorrhea,appearing acnes and so on.Conclusion: LNG-IUS is an effective method in the conservative treatment of adenomyosis.It is suit for the adenomyosis patients with the dysmenorrheal and/or heavy menstruation symptoms.