曼月乐治疗子宫腺肌病的临床观察

目的：探讨左炔诺孕酮宫内缓释系统（LNG-IUS,商品名：曼月乐）在治疗子宫腺肌病中的临床疗效及安全性。方法：将笔者所在医院妇科就诊有治疗意愿的子宫腺肌病伴中度或重度痛经及月经过多的患者48例,放置曼月乐进行治疗,观察曼月乐治疗前、治疗后3个月、6个月、12个月的痛经程度、月经量、血红蛋白、血清CA125水平、子宫体积变化、子宫内膜厚度变化等情况。结果：曼月乐治疗后3个月患者痛经明显缓解,月经量明显减少,子宫内膜厚度变薄,与放置前相比较,差异均有统计学意义（P〈0.05）;10例贫血患者放置（LNG-IUS）3个月、6个月、12个月后血红蛋白升高,与放置前相比较差异有统计学意义（P〈0.05）;血清CA125在放置后12个月明显下降,与放置前比较差异有统计学意义（P〈0.05）。子宫体积稍有缩小,但与放置前相比较差异均无统计学意义（P〉0.05）。不良反应主要表现有4例阴道点滴出血、3例闭经、1例乳房胀痛、1例环脱落,其他未见不良反应。结论：曼月乐对子宫腺肌病的治疗安全有效,有较好的临床应用价值。

Clinical Observation of LNG-IUS in Treatment of Adenomyosis

Objective： To investigate clinical efficacy and safety of Mirenain （ levonorgestrel-releasing intrauterine system, LNG-IUS ）remedied adenomyosis.Method： A tatle of 48 female adenomyosis patients who were suffering from severe dysmenorrhea and menorrhagia volunteered for inserting Mirena in our hospital.The degree of dysmenorrhea, menstruation, hemoglobin, level of CA125 in serum and both of the change in uterine volume and endometrial were compared between befor insertion and after it for 3, 6, 12 months.Result： All patients had remitted dysmenorrheal, reduced menstruation obviously and their endometrial had thin, during the fisrt 3 months.It was signifcant by comparing wirh before insertion.During the flrsr 3 months, the second and the fourth , 10 anemia patients＇ hemoglobin grew up , comparing with befor insertion significantly （ P〈0.05 ） .CA125 level in serum of all patients decreased after 12 months, comparing with before inserting significantly （ P〈0.05 ） .Uterine volume slightly reduced which was not signifieant（ P〉0.05 ） compared with before insertion.There were 9 patients had side-effects ： 4 abnormal hemorrhage, 3 amenorrhea, 1 swollen breasts , 1Mirenaexpulsion.Conclusion： Mirena was proved to be not only safe, effeiaeiousbut also valuable forelinical applieationinadenomyosistreament.