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目的:比较左炔诺孕酮宫内缓释系统(LNG-IUS)与长效醋酸甲羟孕酮(Depot-MPA)治疗子宫内膜异位症的临床疗效。方法:保守性手术后即刻或单纯疼痛复发后患者87例,42例放置LNG-IUS,45例在3年内每隔3个月肌注长效醋酸甲羟孕酮(Depot-MPA)150 mg,比较临床症状控制情况、复发率、依从性、骨密度。结果:两种治疗方案均能控制临床疼痛症状及复发率。LNG-IUS治疗组患者依从性优于长效醋酸甲羟孕酮治疗组。LNG-IUS治疗组腰椎及股骨颈Wards三角区骨密度(BMD)变化幅度比长效醋酸甲羟孕酮治疗组大。结论:LNG-IUS治疗组可以有效地控制子宫内症膜异位症的临床症状和复发率,患者依从性好,骨密度可以得到改善,而长效醋酸甲羟孕酮治疗组出现骨密度下降。
Objective: To compare the clinical efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) with long-acting Depot-MPA in the treatment of endometriosis. Methods: Eighty-seven patients were followed up immediately after conservative surgery or simple pain. Forty-two patients underwent LNG-IUS. 45 patients were injected with 150 mg long-acting Depot-MPA every 3 months for 3 years. Compare the control of clinical symptoms, relapse rate, compliance, bone mineral density. Results: Both treatment regimens controlled clinical symptoms and recurrence of pain. Patients in LNG-IUS group had better compliance than long-term medroxyprogesterone acetate group. The BMD of lumbar and femoral neck in LNG-IUS group was larger than that of long-term medroxyprogesterone acetate group. CONCLUSION: LNG-IUS treatment group can effectively control the clinical symptoms and recurrence rate of metrorrhagia. The patient compliance is good, the BMD can be improved, and the long-acting medroxyprogesterone acetate treatment group shows a decrease in bone mineral density .