腹腔镜切除术联合左炔诺孕酮宫内缓释系统对子宫腺肌症的治疗效果观察

摘要

目的 探讨采用腹腔镜切除术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌症的临床疗效.方法 在2014年9月至2016年5月期间本院收治的子宫腺肌症患者中选取84例,所有患者均采用腹腔镜切除术联合左炔诺孕酮宫内缓释系统进行治疗,同时根据左炔诺孕酮宫内缓释系统的放置时间不同将其分为同步组和延迟组,对所有患者治疗前其月经量、子宫体积、痛经等临床症状变化情况进行观察分析.结果 84例患者经治疗后,其子宫体积、痛经程度、月经量[分别为(75.6±27.9) cm3、(1.3±0.9分)(72.4±18.5)分]均较术前[(192.9±85.0) cm3、(7.2±1.5)分、(217.2±87.7)分]明显改善,差异均有统计学意义(均P＜ 0.05);同步组与延迟组在术后不同时期相关指标比较差异无统计学意义(P＞0.05),但前者节育器相关并发症发生率(33.33％)明显高于后者(11.90％),差异有统计学意义(P＜0.05).结论 采用腹腔镜切除术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌病可有效促进患者临床症状的改善,在术后1个月左右延迟放置节育器可取得较好的稳定性,有助于减轻患者不必要的痛苦,促进左炔诺孕酮作用的稳定发挥.%Objective To explore the clinical effect of laparoscopic resection combined with levonorgestrel intrauterine sustained release system in the treatment of adenomyosis.Methods 84 patients with adenomyosis treated at our hospital from September,2014 to May,2016 were selected and all were treated with laparoscopic resection and levonorgestrel intrauterine sustained-release system.According to the different placing times of norethindrone intrauterine sustained release system,the patients were divided into a synchronous group and a delayed group.The changes of clinical symptoms,such as menstrual volume,uterine volume,and dysmenorrhea were observed and analyzed before treatment.Results The uterine volume,degree of =dysmenorrheal,and menstrual volume were (75.6±27.9) cm3,(1.3±0.9),and (72.4±18.5) after treatment and were (192.9±85.0) cm3,(7.2±1.5),and (217.2±87.7) before treatment in the 84 patients,with statistical differences (all P ＜ 0.05).There were no statistical differences in the related indicators between the synchronous group and the delayed group (P ＞ 0.05),but the complication rate of the IUD was significantly higher in the synchronous group than in the delayed group (11.90％ vs.33.33％,P ＜ 0.05).Conclusions Laparoseopic resection combined with levonorgestrel intrauterine sustained release system in the treatment of adenomyosis can effectively improve the clinical symptoms;the placement of 1UD 1 month after the operation can achieve better stability;it can reduce unnecessary pain in patients and make levonorgestrel be stably effective.