左炔诺孕酮宫内缓释系统治疗子宫内膜增生过长的临床疗效

目的探讨左炔诺孕酮宫内节育系统(曼月乐)对子宫内膜增生的临床疗效。方法观察12例诊断为子宫内膜增生的患者,放置LNG-IUS。放置前,对门诊就诊患者进行诊断性刮宫,子宫内膜病理活检;放置后,每隔3个月随访1次,研究子宫内膜复原时间及复原率。结果本组12例患者中,4例为子宫内膜单纯性增生,无非典型性增生;7例为子宫内膜复杂性增生,无非典型性增生;仅1例患者为子宫内膜复杂非典型性增生。所有患者子宫内膜在放置LNG-IUS后均得到治愈(100%,12/12)。3个月内,子宫内膜得到明显改善(66%,8/12),子宫内膜转归平均时间为4.5个月。12例患者转归时间为9个月。放置LNG-IUS后,子宫内膜复杂性非典型性增生患者子宫内膜转归时间为9个月,平均随访时间为12个月(3~27个月)。通过宫腔内放置LNG-IUS后,子宫内膜增生得到有效治疗。结论 LNG-IUS是治疗子宫内膜增生症的一种较为有效且安全的方法 。

Effects of the Levonorgestrel-releasing Intrauterine System in the Treatment of Endometrial Hyperplasia

Objective To investigate the effect of Levonorgestrel-releasing intrauterine system（LNG-IUS）in the treatment of endometrial hyperplasia（EH）.Methods A total of 12 women with endometrial hyperplasia were enrolled and treated with LNG-IUS insertion.Baseline endometrial biopsies were done before insertion of LNG-IUS.Follow-up endometrial biopsies of outpatient were taken at 3-month intervals after insertion of LNG-IUS.To investigated the regression rate and the time to regression.Results Four patients had simple hyperplasia without atypia,seven patients had complex hyperplasia without atypia,and just one patient had complex atypical hyperplasia.Complete regression of EH was achieved in all cases（100%,12/12）,the endometrium were significantly improved within three months with the significant proportion（66%,8/12）.The mean time of regression was 4.5 months.All cases had regression within nine months.In the case of complex atypical hyperplasia,the regression was attained at the nineth month after insertion of LNG-IUS.The mean follow-up duration was 12 months（three to twenty-seven months）.LNG-IUS has higher effect for the treatment of EH.Conclusion Levonorgestrel-releasing intrauterine system（LNG-IUS） might be effect in symptom control and prevention of recurrence of endometrial hyperplasia.