曼月乐分别联合GnRHa金属圆环治疗子宫腺肌病的疗效观察  

Observation and comparison of the therapeutic effect of mirena combined with GnRHa or Metal Ring on adenomyosis

作　　者：李飞飞 李佩佩 LI Fei-fei;LI Pei-pei(Gynecology of Obstetrics,Wenzhou People's Hospital,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州市人民医院妇产科,浙江温州325000

出　　处：《中国妇幼保健》2024年第20期3940-3943,共4页Maternal and Child Health Care of China

基　　金：浙江省温州市科学技术局资助项目(Y20210332)。

摘　　要：目的探究曼月乐分别联合GnRHa、金属圆环治疗子宫腺肌病的疗效,为子宫腺肌病的治疗方法选择提供科学的依据。方法选取2021年7月—2022年12月于温州市人民医院就诊的120例子宫腺肌病患者为研究对象,随机分为A组45例(放曼月乐),B组45例(GnRHa+曼月乐),C组30例(双环:曼月乐+圆环)。比较3组患者放环前后月经量、子宫体积大小、痛经、血红蛋白值、CA125值、曼月乐下移/脱落、不良反应及满意度情况。结果3组患者月经量、痛经、血红蛋白量及CA125值在随访各个阶段均有明显变化,差异均有统计学意义(均P<0.05);在曼月乐有下移/脱落和无下移/脱落患者中比较发现,治疗前子宫体积[(251.45±52.79)cm^(3),(214.59±43.40)cm^(3)]、治疗前月经量评分[(211.10±26.57)分,(179.71±27.75)分]是影响曼月乐下移/脱落的危险因素,差异有统计学意义(F=6.381、12.023,均P<0.05)。3组患者在不同方法治疗后,曼月乐下移/脱落数不同,差异有统计学意义(F=28.732,P<0.05)。B组在放环后6月内累计出现阴道点滴出血12例,和A组和C组相比,差异有统计学意义(F=3.248,P=0.042)。B组中有36例(86.67%)对GnRHa联合曼月乐治疗效果非常满意,差异有统计学意义(χ^(2)=11.249,P=0.004)。结论GnRHa预处理后放曼月乐在子宫内的下移/脱落发生率最低,且术后阴道不规则点滴出血发生情况最少,患者满意度最高。因此,GnRHa联合曼月乐治疗子宫腺肌病效果显著,性价比更高,可在临床推广使用。Objective To explore the curative effect of LNG-IUS combined with GnRHa or Metal Ring on adenomyosis,so as to provide scientific basis for the treatment of adenomyosis.Methods Research object selection method:120 cases of adenomyosis were selected as the research objects.They were divided into Group A(45 cases,LNG-IUS),Group B(45 cases,GnRHa with LNG-IUS)and Group C(30 cases,LNG-IUS with Ring).Compared the menstrual volume,uterine volume,dysmenorrhea,hemoglobin value,CA125 value,downward displacement/shedding of Mirena,adverse reactions,and satisfaction of three groups before and after IUS insertion.Results The menstrual volume,dysmenorrhea,hemoglobin volume,and CA125 value of the three groups showed significant changes at various stages of follow-up,and the differences were statistically significant(P<0.05).A comparison between patients whether or not downward/falling off of Manyule showed that pre-treatment uterine volume[(251.45±52.79)cm^(3),(214.59±43.40)cm^(3)]and pre-treatment menstrual volume score[(211.10±26.57)points,(179.71±27.75)points]were the risk factors for downward/falling off of LNG-IUS,and the differences were statistically significant(F=6.381,12.023,all P<0.05).Three groups of patients showed statistically significant differences in the number of downward/falling off of LNG-IUS after treatment with different methods(F=28.732,P<0.05).Within 6 months after LNG-IUS insertion,a total of 12 individuals in Group B experienced vaginal drip bleeding,with a statistically significant difference compared to Group A and Group C(F=3.248,P=0.042).36 patients(86.67%)in Group B were very satisfied with the treatment effect of GnRHa combined with LNG-IUS,and the difference was statistically significant(χ^(2)=11.249,P=0.004).Conclusion The incidence of the downward/falling off of LNG-IUS in uterine was the lowest after GnRHa pretreatment,and the incidence of postoperative irregular vaginal bleeding was the lowest,and the patients'satisfaction was the highest.Therefore,GnRHa combined with LNG-IUS has more si

关 键 词：曼月乐 金属圆环 子宫腺肌病 促性腺激素释放激素激动剂 

分 类 号：R711.71[医药卫生—妇产科学]