左炔诺孕酮宫内缓释系统在子宫内膜异位症术后患者中的应用效果

摘要

目的：探讨左炔诺孕酮宫内缓释系统(LNG-IUS)在子宫内膜异位症术后患者中的应用效果。方法选取2010年1月~2012年1月因子宫内膜异位症在本院行腹腔镜保守性手术治疗的患者60例随机分为两组，A组30例采用LNG-IUS治疗，B组30例采用孕三烯酮治疗。随诊两年，比较术前及治疗后的血清CA125、E2水平、VAS和治疗后2年的两组复发率。结果两组治疗后的CA125水平与术前比较差异有统计学意义(P<0.01)；两组治疗后2年的CA125水平比较差异有统计学意义(P<0.05)。 B组治疗后6个月、1年的血清E2水平与术前比较差异有统计学意义(P<0.05)。治疗后6个月，两组血清E2水平比较差异有统计学意义(P<0.05)。两组治疗后VAS与术前比较差异有统计学意义(P<0.01)；治疗后1、2年，两组VAS比较差异有统计学意义(P<0.05)。治疗后2年，A组复发率明显低于B组，差异有统计学意义(P<0.05)。结论 LNG-IUS用于子宫内膜异位症术后辅助治疗，对卵巢功能影响较小，患者满意度高、依从性好、复发率低，阴道不规则流血是其主要副反应。%Objective To investigate application effect of levonorgestrel-releasing intrauterine system (LNG-IUS)in the treatment of endometriosis after conservasive laparoscopic surgery. Methods 60 patients with laparoscopic conservative operation therapy in our hospital from January 2010 to January 2012 were selected and randomly divided into 2 groups, LNG-IUS was used in group A(30 cases),gestrinone was used in group B(30 cases).Followed-up of two years,serum car-cinoembryonic antigen(CA125),serum estradiol(E2)level and VAS before surgery and after treatment was compared re-spectively.After treatment for 2 year,the recurrence rate of two groups was compared. Results After treatment,CA125 level in two groups was compared with before surgery respectively,there was statistical difference (P<0.01).After treat-ment of 2 years,CA125 level in two groups was compared,there was statistical difference (P<0.05).After treatment of 6-month and 1-year,E2 level in group B was compared with before surgery respectively,there was statistical difference(P<0.05).After treatment of 6-month,E2 level in two groups was compared,there was statistical difference (P<0.05).After treatment,VAS in two groups was compared with before surgery respectively,there was statistical difference (P<0.01).Af-ter treatment of 1-year and 2-year,VAS in two groups was compared respectively,there was statistical difference (P<0.05).After treatment of 2-year,the recurrence rate of group A was lower than that of group B,with statistical difference (P<0.05). Conclusion LNG-IUS applied in endometriosis adjuvant therapy has smaller impact on ovarian function,high patient satisfaction,better compliance and relapse rate.Irregular vaginal bleeding is its main side effect.