子宫内膜消融术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌病的临床效果  

Clinical effect of endometrial ablation combined with Levonorgestrel-Releasing Intrauterine System in the treatment of adenomyosis

作　　者：王爽[1] 张晓玲[1] 黄冬花[1] 袁媛 谢小花 WANG Shuang;ZHANG Xiaoling;HUANG Donghua;YUAN Yuan;XIE Xiaohua(Department of Gynecology,Jiangxi Maternal and Child Health Hospital,Jiangxi Province,Nanchang 330006,China)

机构地区：[1]江西省妇幼保健院妇科,江西南昌330006

出　　处：《中国当代医药》2025年第4期84-87,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202310932)。

摘　　要：目的探讨子宫内膜消融术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌病(AM)的临床效果。方法选取2021年4月至2023年4月江西省妇幼保健院收治的60例AM患者为研究对象,按随机数字表法分为对照组(30例)和研究组(30例)。对照组采用左炔诺孕酮宫内缓释系统治疗,研究组采用子宫内膜消融术联合左炔诺孕酮宫内缓释系统治疗。比较两组的治疗效果、月经情况、子宫内膜厚度、性激素指标、糖类抗原125(CA125)水平,以及不良反应发生情况。结果研究组的总有效率高于对照组,差异有统计学意义(P<0.05)。研究组治疗后的痛经评分、月经量评分、子宫内膜厚度、CA125水平均低于对照组,差异有统计学意义(P<0.05)。研究组治疗后的雌激素(E2)、卵泡刺激素(FSH)、黄体生成素(LH)水平均高于对照组,差异有统计学意义(P<0.05)。两组均未发生明显不良反应。结论AM患者采用子宫内膜消融术联合左炔诺孕酮宫内缓释系统治疗效果确切,可改善患者月经状况,降低CA125水平,减小子宫内膜厚度,且对性激素水平影响小,无明显不良反应,临床应用安全可靠,值得推广应用。Objective To explore the clinical effect of endometrial ablation combined with Levonorgestrel-Releasing Intrauterine System in the treatment of adenomyosis(AM).Methods A total of 60 AM patients admitted to Jiangxi Maternal and Child Health Hospital from April 2021 to April 2023 were selected as the research objects.According to the random number table method,they were divided into control group(30 cases)and study group(30 cases).The control group was treated with Levonorgestrel-Releasing Intrauterine System,and the study group was treated with endometrial ablation combined with Levonorgestrel-Releasing Intrauterine System.The treatment effect,menstruation,endometrial thickness,sex hormone index,carbohydrate antigen 125(CA125)level,and adverse reactions were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).The dysmenorrhea score,menstrual volume score,endometrial thickness and CA125 level of the study group after treatment were lower than those of the control group,and the differences were statistically significant(P<0.05).The levels of estrogen(E2),follicle stimulating hormone(FSH)and luteinizing hormone(LH)in the study group after treatment were higher than those in the control group,and the differences were statistically significant(P<0.05).No obvious adverse reactions occurred in the two groups.Conclusion Endometrial ablation combined with Levonorgestrel-Releasing Intrauterine System is effective in the treatment of AM patients,which can improve the menstrual status of patients,reduce the level of CA125 and endometrial thickness,and has little effect on sex hormone levels without obvious adverse reactions.The clinical application is safe and reliable,and it is worthy of promotion and application.

关 键 词：子宫腺肌病 子宫内膜消融术 左炔诺孕酮宫内缓释系统 临床效果 

分 类 号：R711.7[医药卫生—妇产科学] R713.4[医药卫生—临床医学]