3889例左炔诺孕酮宫内缓释系统临床应用分析  

Clinical Analysis of 3889 Cases of Levonorgestrel Intrauterine System

作　　者：刘小艳[1,2] 罗静雯[1,2] 杨合荣[1,2] 王江[1,2] 王惠[1,2] 常青[1,2] 

机构地区：[1]第三军医大学第一附属医院 [2]重庆西南医院,重庆400038

出　　处：《实用妇产科杂志》2013年第5期376-379,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨左炔诺孕酮宫内缓释系统(LNG-IUS)的临床适应证、临床效果、相关副反应及处理对策,以提高续用率。方法:回顾分析近10年我院3889例放置LNG-IUS女性临床资料及随访情况。结果:放置LNG-IUS指征排序:避孕3090例、痛经(包括子宫内膜异位症和子宫腺肌病)610例、月经量过多(包括单纯性子宫内膜增生过长)172例;无一例带器受孕,避孕有效率100%;治疗月经量过多有效率93.60%,痛经缓解率97.70%;LNG-IUS放置后常见副反应排序:阴道点滴流血(17.23%)、闭经(11.34%)、阴道分泌物增多(2.75%)等。除去有生育要求取LNG-IUS者,因症取LNG-IUS发生率为10.70%,取LNG-IUS前3位原因分别是闭经(3.52%)、阴道点滴流血(1.65%)和面部色素沉着(1.29%)。结论:LNG-IUS不仅可作为主要的避孕方式,而且可作为治疗月经量过多和子宫内膜异位症/子宫腺肌病引起的痛经的一线治疗方案;术前充分知情告知,术后规范随访,副反应及时对症处理,可降低LNG-IUS取器率。Objective：To analysis the clinical indications,clinical effects,associated side-effects and countermeasures of Levonorgestrel intrauterine system（ LNG-IUS）, and eventually to improve the renewal rate of LNG-IUS and patients＇ satisfaction. Methods： Retrospective analysis of the follow-up data of 3889 cases treated with LNG-IUS in the past 10 years. Results：The indications of the LNG-IUS are ranking as：contra- ception 3090 cases,dysmenorrhoea（including endometriosiS and adenomyosis）610 cases,and menorrhagia （including Simple hyperplasia of endometrium）172 cases, the success rate for contraception is 100% ;the ef- fective rate for menorrhagia is 93. 6% ; and the dysmenorrhea remission rate is 97. 7%. The common side I effects included vaginal spotting （ 17. 23% ）, menostasis （ 11.34% ）, and increased vaginal secretions （2. 75% ） ,etc. Besides the fertility requirements,there was 10. 70% rate of removal LNG-IUS,due to amenorrhea（3. 52% ）, vaginal spotting （ 1.65% ） and facial pigmentation （ 1.29% ）. Conclusions： LNG-IUS is an efficient contraception method,and can be used as the main therapy for dysmenorrhoea cuased by endometriosis/adenomyosis and menorrhagia. Sufficient preoperative explanation, postoperative follow-up and timely treatments to side effects,would be helpful to increase the satisfaction of levonorgestrel and decrease the removal rate.

关 键 词：左炔诺孕酮宫内缓释系统 避孕 月经量过多 痛经 副反应 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]