76例子宫内膜异位症术后置左炔诺孕酮宫内节育器的临床研究及安全性观察

目的探讨左炔诺孕酮宫内缓释系统（LNG—IUS）辅助治疗子宫内膜异位症患者保守性术后的临床疗效及安全性。方法观察76例子宫内膜异位症术后放置左炔诺孕酮宫内节育器后的痛经程度、月经量、激素水平变化、CA125值的变化及副反应。结果76例患者在带器期间痛经缓解率为100％，治疗前后差异比较，有统计学意义（P〈0．05）；月经量明显减少（P〈0．05）；CA125值明显降低至正常范围，且维持在较低水平（P〈0．05）；放置后卵巢激素正常，雌二醇与放置前相比无显著差异（P〉0．05）。结论子宫内膜异位症且无生育要求的患者，术后辅以置左炔诺孕酮宫内节育器疗效较好，不会引起体内雌二醇水平下降，再次复发率低，患者依从性好。其主要不良反应为不规则子宫出血。

Effect of Levonorgestrel Releasing Intrauterine Device Placed in 76 Postoperative Cases of Endometriosis

Objective To discuss the clinical outcome oflevonorgestrel releasing intrauterine（LNG-IUD） placed in postoperative uterine of patients with endometriosis. Methods By observing the severity of dysmenorrhea and the menstrual blood volume and the serum steroid and CA125 and adverse effect on 76 LNG-IUD placed cases with endometriosis. Results Menstruation pain was relieved of endometriosis postoperative cases with LNG-IUD. Treatment in front and back comparison. Significandy decreased in amount of menstrual bleeding. Level CA125 significantly was decreased to normal range, and maintained in lower level since then. The ovary hormone is normal after place, the aquadiol level maintains the egg chamber earlier period level, the level of aquadiol have no statistical significance in difference compared with before place. Conclusion Placing LNG-IUD as accessory treatment for postoperative patients with endometriosis is effective, with the convenience and good patients＇ compliance. But irregular bleeding and spotting is the main side effects.