左炔诺孕酮宫内缓释系统治疗子宫腺肌病临床疗效及安全性观察  

Clinical efficacy and safety of levonorgestrel intrauterine sustained-release system in the treatment of adenomyosis

作　　者：吴佳佳 冯冠男[2] 

机构地区：[1]惠州市第一妇幼保健院,广东惠州516000 [2]苏州市立医院东区妇产科,江苏苏州215001

出　　处：《牡丹江医学院学报》2017年第6期47-51,共5页Journal of Mudanjiang Medical University

摘　　要：目的探讨分析左炔诺孕酮宫内缓释系统治疗子宫腺肌病临床疗效及安全性。方法选取90例子宫腺肌病随机分为观察组和对照组,观察组患者给予左炔诺孕酮宫内缓释系统治疗,对照组患者给予孕三烯酮治疗,比较两组患者治疗前后血清性激素水平,治疗前、治疗后3、6、12、24个月子宫内膜厚度、VAS评分、子宫体积、月经量及不良反应发生情况。结果治疗后观察组患者与治疗前FSH、E2、LH血清激素水平差异无统计学意义(P>0.05),而对照组患者较治疗前FSH、E2、LH血清激素水平显著下降,差异均具有统计学意义(P<0.05),观察组患者治疗后3、6、12、24个月VAS评分显著下降、子宫内膜厚度持续变薄、子宫体积逐渐缩小、月经量显著减少,对照组患者治疗后3、6个月VAS评分显著下降、子宫内膜厚度持续变薄、子宫体积逐渐缩小、月经量显著减少,但是6个月后VAS评分逐渐提高,子宫内膜厚度变厚,子宫体积增大,月经量增多,差异均具有统计学意义(P<0.05),但治疗后12、24个月两组患者子宫内膜厚度差异无统计学意义(P>0.05),两组患者不良反应发生率差异无统计学意义(P>0.05)。结论左炔诺孕酮宫内缓释系统治疗子宫腺肌病患者的性激素水平更加稳定,患者痛经、子宫内膜增厚、子宫体积增大、月经量增多等临床症状的改善更为显著,且安全性较高,值得在临床上广泛推广。Objective To explore the clinical efficacy and safety of levonorgestrel in intrauterine sustained - release system for the treatment of adenomyosis. Methods To select 90 cases of adenomyosis and divide them into observation group and control group randomly. The patients in the observation group were given levonorgestrel intrauterine sustained -release system and the control group was treated with triclosterone. To compare the levels of serum sex hormones before and after treatment between the two groups before and after treatment, endometrlal thickness, VAS score, uterine volume, menstrual flow and adverse reaction occurred at 3, 6, 12 and 24 months after treatment. Results There was no significant difference in serum hormone levels between FSH, E2 and LH before treatment （P 〉 0. 05 ）, but the serum levels of FSH, E2 and LH in the control group were significantly lower than those in the control group （ P 〈0.05 ）. The VAS score of the observation group was significantly decreased at 3, 6, 12 and 24 months after treatment, the thickness of the endometrium was thinned, the uterine volume gradually decreased, the menstrual flow was significantly reduced, the control group was treated The VAS score was significantly decreased, the thickness of the endometrium increased, the uterine volume gradually decreased, the menstrual volume decreased significantly, but the VAS score increased gradually after 6 months, the thickness of the endometrium increased, the uterus increased （P 〈 0.05 ）. However, there was no significant difference in endometrial thickness between the two groups at 12 and 24 months after treatment （P 〉 0.05 ）. There was no significant difference in the incidence of adverse reactions between the two groups. The difference was statistically significant （P 〉 0.05 ）. Conclusion Levonorgestrel intrauterine sustained - release system is more stable in patients with adenomyosis, and the improvement of clinical symptoms such as dysmenorrhea, endometrial thickening, uterine volume inc

关 键 词：左炔诺孕酮宫内缓释 子宫腺肌病 临床疗效 安全性 

分 类 号：R71[医药卫生—妇产科学]