左炔诺孕酮宫内缓释系统治疗子宫内膜病变的临床观察  

Effectiveness of Levonorgestrel-releasing Intrauterine System in the Treatment of Endometrium Lesion

作　　者：李瑜[1,2] 滕芳[1] 傅士龙[1] 卫红[1] 韩素萍[1] 

机构地区：[1]南京医科大学第一附属医院,江苏南京210029 [2]同济大学附属第一妇婴保健院,上海200040

出　　处：《实用妇产科杂志》2010年第10期749-751,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:观察左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫内膜增殖性病变及早期子宫内膜癌的疗效、药物不良反应及患者的满意度,为此类疾病寻找新的治疗方法。方法:采用病例对照研究方法,对经组织病理学确诊为子宫内膜增殖性病变及早期子宫内膜癌的15例患者放置LNG-IUS。放置后每3个月1次行子宫内膜组织病理检查,直至内膜转化成分泌期;同时观察子宫内膜厚度、月经改变、药物不良反应及患者的满意度等。结果:放置LNG-IUS后所有患者均完成治疗及随访。15例患者均在放置LNG-IUS后第1个月月经量开始减少,第3个月月经量为放置前的1/20～1/10(P<0.05);放置LNG-IUS3个月后子宫内膜厚度由8.9～25.0mm(中位15.56mm)变为3.2～5.2mm(中位4.6mm)(P<0.05)。放置3～9月后所有病变内膜均转化呈分泌期样子宫内膜或子宫内膜间质呈蜕膜样变。患者对治疗的满意度为100%。结论:LNG-IUS治疗子宫内膜增殖性病变及早期子宫内膜癌的近期疗效好,病变内膜多在3～9月转化正常。患者依从性及耐受性良好,满意度高,便于随访,有望成为治疗子宫内膜增殖性病变的理想方法。Objective：To observe the effectiveness,side effects and patient satisfaction of LNG-IUS in the treatment of endometrial hyperplasia and early endometrial cancer,and to find a new treatment for this disease.Methods：Case control study was used.LNG-IUS was inserted into 15 patients,who were diagnosed as endometrial hyperplasia or endometrial cancer by histopathology.All patients were followed up every 3 months for endometrium pathological examination till the endometrium turned to secretory phase.At the same time,endometrium thickness,menstruation change,side effects and patient satisfaction were observed.Results：All patients had finished the follow-up after LNG-IUS insertion.Menstrual blood volume decreased from the first month after the insertion,and at the third month the volume was 1/20 to 1/10 of that before insertion （P0.05）.The endometrium thickness was changed from 8.9～25.0 mm （median was 15.56 mm） to 3.2～5.2 mm （median was 4.6 mm） 3 months after insertion （P0.05）.3～9 months after insertion,all lesion endometrium were changed to secretory endometium or endometrial stroma showed decidual changes.The degree of satisfaction to treatment was 100%.Conclusions：LNG-IUS has short-term good effect in the treatment of endometrium proliferation diseases,and early stage of endometrial cancer.The lesion endometrium can change to normal at 3～9 months after the insertion of LNG-IUS.It has good compliance,tolerance,high satisfaction and easy to follow up.It appears to be an ideal method to treat endometrium lesion.

关 键 词：左炔诺孕酮宫内缓释系统 子宫内膜增殖 子宫内膜不典型增殖 子宫内膜癌 

分 类 号：R711.32[医药卫生—妇产科学]