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目的:探讨左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫腺肌病(AM)的临床疗效。方法:对67例AM患者子宫内放入LNG-IUS,检测放置前、放置后1、3、6、12、24个月的月经量、痛经情况、子宫内膜厚度、子宫体积以及血清中的血红蛋白(Hb)、促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E_2)等指标的变化。结果:放置LNG-IUS后,患者的月经量在3个月后较放置前明显减少(P<0.05),痛经在放置3个月后较放置前明显减轻(P<0.05),子宫内膜厚度在放置1个月后较放置前明显变薄(P<0.05),子宫体积在放置1年后明显缩小(P<0.05),血清Hb水平在放置6个月后较放置前明显上升(P<0.05),血清FSH、LH、E_2水平放置前、后无统计学差异(P>0.05)。结论:LNG-IUS能有效缓解AM患者痛经、减少月经量、改善子宫内膜厚度并在一定程度上缩小子宫体积、提高血清Hb水平,且不会影响患者卵巢功能,是治疗AM的一种有效方法。
Objective: To investigate the clinical efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of adenomyosis (AM). Methods: LNG-IUS was put into the uterus of 67 cases of AM patients. The menstrual flow, dysmenorrhea, endometrial thickness, uterine volume, and the serum levels in the serum before and after 1, 3, 6, 12 and 24 months Hemoglobin (Hb), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E_2) and other indicators of change. Results: After LNG-IUS was placed, the amount of menstrual flow in patients after 3 months was significantly decreased (P <0.05), dysmenorrhea was significantly reduced after 3 months (P <0.05), endometrial thickness (P <0.05). The volume of uterus contracted significantly (P <0.05) after 1 month and the level of serum Hb increased significantly after 6 months (P < 0.05). Serum levels of FSH, LH and E2 were not significantly different between before and after treatment (P> 0.05). CONCLUSION: LNG-IUS can effectively relieve dysmenorrhea, reduce menstrual flow, improve endometrial thickness and reduce uterine volume and serum Hb level in AM patients without affecting ovarian function in patients with AM, which is an effective treatment for AM method.