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目的:探讨左炔诺孕酮功内缓释系统(LNG-IUS)用于子宫腺肌病患者治疗的效果。方法:选择因子宫腺肌病而就诊的患者32例,于月经周期第3~7天宫内放置LNG-IUS。所有患者均无生育要求且不愿手术。于放置LNG-IUS后3、6、12、24和36个月随访,观察放置LNG-IUS前后患者疼痛视觉模拟(VAS)评分、月经情况、体质量等指标。结果:1VAS评分:放置LNG-IUS后12个月,痛经、慢性盆腔痛或性交痛缓解最为明显,VAS评分由放置LNG-IUS前的(6.0±2.2)分、(4.1±2.1)分下降至(1.1±0.7)分、(1.3±0.9)分,分别比较差异有统计学意义(P<0.01)。2放置LNG-IUS后3~6个月内,阴道不规则出血或点滴出血是常见现象,随放置时间的延长,情况明显缓解。少数患者出现体质量的增加和乳房胀痛等情况。结论:子宫腺肌病的患者,应用LNG-IUS可有效地缓解痛经症状,减少月经量,是一种有效、安全、持续时间长、全身不良反应少、依从性高的治疗方法。
Objective: To investigate the efficacy of levonorgestrel-administered intra-articular sustained release system (LNG-IUS) in the treatment of patients with adenomyosis. Methods: Thirty-two patients with adenomyosis were enrolled in the study. LNG-IUS was placed intrauterine in the third to seventh days of the menstrual cycle. All patients had no fertility requirements and did not want surgery. The patients were followed up for 3, 6, 12, 24 and 36 months after placement of LNG-IUS. The pain visual analogue (VAS) scores, menstrual status and body weight before and after LNG-IUS placement were observed. Results: 1VAS score: The most obvious symptom of dysmenorrhea, chronic pelvic pain or painful intercourse was at 12 months after LNG-IUS was placed. The VAS score decreased from (6.0 ± 2.2), (4.1 ± 2.1) before LNG-IUS (1.1 ± 0.7) points, (1.3 ± 0.9) points, respectively, the difference was statistically significant (P <0.01). 2 placed LNG-IUS after 3 to 6 months, irregular vaginal bleeding or bleeding is a common phenomenon, with the extension of time, the situation was significantly alleviated. A small number of patients with increased body mass and breast tenderness and so on. CONCLUSIONS: In patients with adenomyosis, the application of LNG-IUS can effectively relieve the symptoms of dysmenorrhea and reduce menstrual flow. It is an effective, safe, long-lasting treatment with few systemic adverse reactions and high compliance.