左炔诺孕酮宫内缓释节育系统与小剂量米非司酮在子宫腺肌病中的治疗效果分析  

Effect analysis of levonorgestrel-releasing intrauterine system and low-dose mifepristone in the treatment of adenomyosis

作　　者：刘文新 李雪杰 LIU Wen-xin;LI Xue-jie(Maternal and Child Health Hospital,Dongchangfu District,Liaocheng 252000,China)

机构地区：[1]山东省聊城市东昌府区妇幼保健院,252000

出　　处：《中国实用医药》2023年第19期35-39,共5页China Practical Medicine

摘　　要：目的探究子宫腺肌病患者实施左炔诺孕酮宫内缓释节育系统(LNG-IUS)联合小剂量米非司酮治疗的临床疗效。方法98例子宫腺肌病患者,利用随机盲选方式分为试验组和参照组,每组49例。参照组患者实施左炔诺孕酮宫内缓释节育系统进行治疗,试验组患者在参照组基础上联合小剂量米非司酮进行治疗。对比两组子宫内膜厚度及子宫体积,月经出血天数、月经失血图(PBAC)评分及痛经视觉模拟评分法(VAS)评分,临床疗效,血红蛋白(Hb)及糖类抗原125(CA125)水平,不良事件发生情况。结果治疗前,两组患者的子宫内膜厚度及子宫体积对比差异无统计学意义(P>0.05);治疗后,试验组患者的子宫内膜厚度(6.47±1.08)mm及子宫体积(113.25±19.18)cm^(3)均小于参照组的(7.92±1.13)mm、(132.59±22.76)cm^(3),差异具有统计学意义(P<0.05)。治疗前,两组月经出血天数、PBAC评分及痛经VAS评分对比差异无统计学意义(P>0.05);治疗后,两组月经出血天数(6.21±1.14)d短于参照组的(8.56±1.86)d,PBAC评分(30.54±7.84)分及痛经VAS评分(1.98±0.92)分低于参照组的(37.69±8.29)、(2.56±1.10)分,差异具有统计学意义(P<0.05)。试验组临床总有效率97.96%明显高于参照组的81.63%,差异具有统计学意义(P<0.05)。治疗前,试验组Hb及CA125水平对比差异无统计学意义(P>0.05);治疗后,试验组Hb(126.28±8.91)g/L高于参照组的(109.54±9.26)g/L,CA125(35.12±9.35)U/ml低于参照组的(43.56±10.12)U/ml,差异具有统计学意义(P<0.05)。两组不良事件发生率对比差异无统计学意义(P>0.05)。结论左炔诺孕酮宫内缓释节育系统联合小剂量米非司酮治疗子宫腺肌病的疗效显著且安全性高,值得临床广泛应用。Objective To investigate the clinical efficacy of levonorgestrel-releasing intrauterine system(LNG-IUS)and low-dose mifepristone in the treatment of adenomyosis.Methods A total of 98 patients with adenomyopathy were randomly divided into the experimental group and reference group,with 49 cases in each group.Patients in the reference group were treated with levonorgestrel-releasing intrauterine system,and patients in the experimental group were treated with low-dose mifepristone based on the reference group.Both groups were compared in terms of endometrial thickness,uterine volume,duration of menstrual bleeding,pictorial blood loss assessment chart(PBAC)score and visual analogue scale(VAS)score,clinical efficacy,hemoglobin(Hb)and carbohydrate antigen 125(CA125)levels,and the occurrence of adverse events.Results Before treatment,there was no statistically significant difference in endometrial thickness and uterine volume between the two groups(P>0.05).After treatment,the endometrial thickness of(6.47±1.08)mm and uterine volume of(113.25±19.18)cm^(3) in the experimental group were lower than those of(7.92±1.13)mm and(132.59±22.76)cm^(3) in the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no statistically significant differences in duration of menstrual bleeding,PBAC scores and dysmenorrhea VAS scores between the two groups(P>0.05).After treatment,the duration of menstrual bleeding of(6.21±1.14)d in the experimental group was shorter than that of(8.56±1.86)d in the control group;PBAC score of(30.54±7.84)points and dysmenorrhea VAS score of(1.98±0.92)points in the experimental group were lower than those of(37.69±8.29)and(2.56±1.10)points in the control group;the difference were statistically significant(P<0.05).The total clinical effective rate of the experimental group was 97.96%,which was significantly higher than that of 81.63%of the reference group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically

关 键 词：左炔诺孕酮宫内缓释节育系统 米非司酮 子宫腺肌病 小剂量 

分 类 号：R711.71[医药卫生—妇产科学]