依托孕烯皮下埋植剂治疗子宫腺肌病的疗效及安全性观察

摘要

目的:评价依托孕烯皮下埋植剂治疗子宫腺肌病的安全性及临床疗效.方法:选择2015年1月至2017年1月就诊的子宫腺肌病(Adenomyoiss,AM)患者30例作为研究对象,均采取依托孕烯皮下埋植剂进行治疗,术后进行随访,分析其避孕效果,痛经缓解程度,治疗月经过多的疗效和不良反应.结果:患者避孕率高达100％.30例子宫腺肌病患者皮下埋植前均不同程度的痛经症状,埋植后3个月,患者痛经程度缓解或消失(P＜0.05).12例有经量增多、经期延长患者治疗1个月、3个月、6个月、12个月后子宫内膜厚度与治疗前对比均变薄(P＜0.05),子宫体积治疗1个月、3个月后较治疗前变化差异无统计学意义(P＞0.05),治疗6个月、12个月均较治疗前缩小(P＜0.05).随访期间主要的不良反应为出血模式的改变.结论:依托孕烯皮下埋植剂治疗子宫腺肌病能够有效缓解患者的痛经程度,还可以治疗月经过多,安全可靠,可在临床上推广应用.%Objective:To evaluate the efficacy and safety of a etonogestrel-releasing implant in treatment of adenomyosis.Methods:30 cases of adenomyosis patients admitted in our hospital from January 2015 to January 2017 were selected as the research object,adopt treatment etonogestrel implants,respectively,on the fifth day after operation,first,3,6,and 12 months postoperatively.The analysis of the contraceptive effect,relieve dysmenorrhea degree,after months of treatment and the curative effect of adverse reactions the degree of dysmenorrhea;using visual analog scale (VAS) assessment.Results:The contraceptive rate is as high as 100％.30 cases of adenomyosis patients had different degrees of dysmenorrhea before subcutaneous implantation,and the degree of dysmenorrhea was relieved or disappeared 3 months after implantation (P ＜0.05).There were 12 cases of menorrhagia,menostaxis patients treated for 1 months,3 months,6 months,12 months after the endometrial thickness compared with before treatment were significantly thinner (P＜0.05),the volume of uterus treated for 1 months and 3 months later was not different from that before treatment(P＞0.05;treatment for 6 months and 12 months was significantly lower than before treatment(P＜0.05).The major adverse effect during the follow-up period was a change in bleeding patterns.Conclusion:The treatment of adenomyosis with subcutaneous implants can effectively relieve dysmenorrhea,and can treat menorrhagia.It is safe and reliable and can be popularized in clinical practice.