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目的探讨子宫腺肌病患者放置左炔诺孕酮宫内缓释系统(LNG-IUS;商品名:曼月乐)后的临床效果。方法2004年9月至2005年11月观察青岛大学医学院附属医院妇产科48例子宫腺肌病患者放置LNG-IUS前、3个月、6个月、12个月痛经评分、PBAC法经量评分、子宫体积及双侧卵巢体积、内膜厚度等多项指标变化。放置LNG-IUS第6、12个月抽取晨血查4项生殖激素:雌二醇(E2)、孕激素(P)、黄体生成素(LH)、卵泡刺激素(FSH)。结果痛经评分于放置前为12.20±2.85,放置后3个月为6.21±3.77,12个月为1.23±0.74,痛经明显减轻,与放置前比较,差异有显著性(P<0.01)。经量评分在放置前为194.47±52.20,放置后3个月为68.64±29.51,12个月为23.68±12.74,较放置前明显减少,差异有显著性(P<0.01)。1年内子宫体积和双侧卵巢体积大小无明显变化(P>0.05)。放置前内膜厚度为(9.3±1.4)mm,3个月内膜厚度为(9.0±1.1)mm(P<0.05),12个月内膜厚度为(6.5±1.1)mm(P<0.01),差异有显著性。放置6个月4项生殖激素维持在卵泡早中期水平,放置1年70%周期有黄体形成。结论LNG-IUS是治疗子宫腺肌病的一种较为有效且安全的方法。
Objective To investigate the clinical effect of levonorgestrel-releasing intrauterine system (LNG-IUS; trade name: Mirena) in patients with adenomyosis. Methods From September 2004 to November 2005, 48 cases of adenomyosis in the obstetrics and gynecology department of Affiliated Hospital of Qingdao University Medical College were observed before and 3 months, 6 months and 12 months after implantation of LNG-IUS, Volume score, the volume of the uterus and bilateral ovarian volume, thickness of the intima and many other indicators. At the 6th and 12th months after LNG-IUS placement, four reproductive hormones, estradiol (E2), progesterone (P), luteinizing hormone (LH) and follicle stimulating hormone (FSH) Results Dysmenorrhea score was 12.20 ± 2.85 before placement, 6.21 ± 3.77 at 3 months after placement, and 1.23 ± 0.74 at 12 months. The dysmenorrhea was significantly relieved. There was significant difference between before and after placement of dysmenorrhea score (P <0.01). The scores of the meridians were 194.47 ± 52.20 before placement, 68.64 ± 29.51 at 3 months after placement, and 23.68 ± 12.74 at 12 months, which was significantly lower than that before placement (P <0.01). There was no significant change in uterine volume and bilateral ovarian volume within 1 year (P> 0.05). The thickness of intima before placement was (9.3 ± 1.4) mm, the thickness of intima at 3 months was (9.0 ± 1.1) mm (P <0.05), the thickness of intima at 12 months was (6.5 ± 1.1) mm , The difference was significant. Place 6 months 4 reproductive hormones maintained at the early and mid-follicle levels, place 1 year 70% of the cycle luteal formation. Conclusion LNG-IUS is a more effective and safe method for the treatment of adenomyosis.