左炔诺孕酮宫内缓释系统治疗子宫腺肌症的疗效观察

摘要

Objective To explore the clinical efficacy and safety of levonorgestrel-releasing in-trauterine system(LNG-IUS)in the treatment of adenomyosis.Methods The LNG-IUS was in-serted during days 3-7 of the menstrual cycle in 92 patients with adenomyosis.The degree of dys-menorrhea,volume of menstrual blood loss,endometrial thickness,uterine volume,and serum lev-els of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),hemoglobin (Hb)and cancer antigen 125(CA125)were measured before and 1-24 months after LNG-IUS in-sertion.Results The degree of dysmenorrhea,volume of menstrual blood loss,endometrial thick-ness,and levels of Hb and CA125 were significantly improved after LNG-IUS insertion(P<0.05).While levels of FSH,LH and E2 were not changed after LNG-IUS insertion(P>0.05). Conclusion The LNG-IUS can effectively improve dysmenorrheal,reduce menstrual blood loss, decrease CA125 level and inhibit disease progression in adenomyosis and has no effect on ovarian function.Therefore,the use of LNG-IUS is a safe conservative treatment for adenomyosis.%目的：探讨左炔诺孕酮宫内缓释系统（LNG-IUS）治疗子宫腺肌症的临床疗效与安全性。方法对92例子宫腺肌症患者于月经周期第3-7天放置 LNG-IUS，观察患者放置前及放置后1～24个月痛经程度、月经情况、子宫内膜厚度、子宫体积、血红蛋白（Hb）、癌抗原125（CA125）、雌二醇（E2）、促黄体生成素（LH）、卵泡刺激素（FSH）的变化。结果放置 LNG-IUS后患者痛经程度、月经情况、子宫内膜厚度、Hb、CA125较放置前均有显著改善（P＜0．05），E2、LH、FSH与放置前比较，差异均无统计学意义（P＞0．05）。结论 LNG-IUS治疗子宫腺肌症能有效控制患者痛经，减少月经量，降低 CA125水平，抑制疾病进展，同时对卵巢功能无明显影响，是一种较为安全的保守治疗手段。