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目的:探讨左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫腺肌病的5年临床疗效。方法:随访2001年4月～2003年5月期间31例放置LNG-IUS的子宫腺肌病患者,观察LNG-IUS治疗前、3个月、6个月、12个月、3年、5年的月经量、痛经VRS评分、子宫体积。LNG-IUS治疗前、治疗后第12个月、3年、5年检测雌二醇(E2)、黄体生成素(LH)、卵泡刺激素(FSH)。结果:治疗前月经量为219.8±49.6,治疗后5年20.2±3.0,较治疗前明显减少,差异有统计学意义(P<0.01)。治疗前平均血红蛋白为79.2±11.5,治疗后5年为128.7±10.9,较治疗前明显改善,差异有统计学意义(P<0.01)。治疗前痛经VRS评分为2.8±0.5,5年后所有患者痛经症状消失,差异有统计学意义(P<0.01)。治疗前子宫体积为739.6±69.8cm3,5年时为129.6±18.3cm3,较治疗前差异有统计学意义(P<0.01)。治疗后血清FSH、LH、E2浓度较治疗前差异无统计学意义(P>0.05)。结论:LNG-IUS治疗子宫腺肌病5年内应用是安全、有效的。
Objective: To investigate the 5-year clinical efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of adenomyosis. Methods: 31 cases of adenomyosis with LNG-IUS placed in our hospital from April 2001 to May 2003 were followed up before, 3 months, 6 months, 12 months, 3 years and 5 years after LNG-IUS treatment Menstrual flow, dysmenorrhea VRS score, uterine volume. Estradiol (E2), luteinizing hormone (LH) and follicle stimulating hormone (FSH) were measured before LNG-IUS treatment at the 12th, 3rd and 5th year after treatment. Results: The amount of menstruation before treatment was 219.8 ± 49.6 and 20.2 ± 3.0 after 5 years of treatment, which was significantly lower than that before treatment (P <0.01). The mean hemoglobin before treatment was 79.2 ± 11.5 and 128.7 ± 10.9 after 5 years of treatment, which was significantly improved compared with that before treatment (P <0.01). Before treatment, VRS score of dysmenorrhea was 2.8 ± 0.5. All patients had dysmenorrhea symptoms disappeared after 5 years, the difference was statistically significant (P <0.01). The uterine volume before treatment was 739.6 ± 69.8 cm3, and that at 5 years was 129.6 ± 18.3 cm3, which was significantly different from that before treatment (P <0.01). After treatment, the serum FSH, LH and E2 concentrations were not significantly different from those before treatment (P> 0.05). Conclusion: LNG-IUS is safe and effective in the treatment of adenomyosis in 5 years.